Individual
JILLIAN JUERGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 CEDAR HILL ST STE 200, MARLBOROUGH, MA 01752-5900
(419) 357-2525
Mailing address
225 CEDAR HILL ST STE 200, MARLBOROUGH, MA 01752-5900
(419) 357-2525
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44045
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846675
—
OH
Enumeration date
09/26/2014
Last updated
07/14/2021
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