Provider Demographics
NPI:1316095698
Name:TOWNSEND, JILL K (MA)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:K
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:K
Other - Last Name:POULAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-498-6509
Mailing Address - Fax:402-498-6357
Practice Address - Street 1:13930 GOLD CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2380
Practice Address - Country:US
Practice Address - Phone:402-334-5880
Practice Address - Fax:402-334-5590
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE192231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist