Provider Demographics
NPI:1225406911
Name:SILL, AILEEN ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:ELIZABETH
Last Name:SILL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:AILEEN
Other - Middle Name:ELIZABETH
Other - Last Name:PEABODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:241 CULVER RD
Mailing Address - Street 2:APT. 1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2358
Mailing Address - Country:US
Mailing Address - Phone:518-928-0719
Mailing Address - Fax:
Practice Address - Street 1:301 SENECA AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-1515
Practice Address - Country:US
Practice Address - Phone:585-266-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist