Individual
JILLIAN PAINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10942 N JACOB SMART BLVD, RIDGELAND, SC 29936-2708
(843) 489-8892
Mailing address
10000 W 75TH ST STE 250, MERRIAM, KS 66204-2218
(888) 913-1910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6908
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6908
SOUTH CAROLINA INTERN LICENSE
SC
Enumeration date
06/14/2019
Last updated
06/14/2019
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