Provider Demographics
NPI:1124429550
Name:REUTTER, JILL (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:REUTTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:S
Other - Last Name:REUTTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:11269 FOREMARK DR
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2209
Mailing Address - Country:US
Mailing Address - Phone:513-532-7381
Mailing Address - Fax:
Practice Address - Street 1:4323 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45205-1507
Practice Address - Country:US
Practice Address - Phone:513-532-7381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 7977235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist