Jill Nolan, MS CCC SLP-L

Individual provider Active NPI Speech-Language Pathologist · Fairview, PA

NPI 1124147889 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124147889
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL007520 (PA)
Practice address
6739 Otten CT
Fairview, PA 16415-3019
Phone
(814) 474-4781
Fax
(814) 474-4782
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL007520PAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL007520 PA Yes

Addresses

Primary practice location

6739 Otten CT
Fairview, PA 16415-3019

Mailing address

6739 Otten CT
Fairview, PA 16415-3019
Phone (814) 474-4781

Other providers in Fairview, PA

All providers in Fairview, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.