Provider Demographics
NPI:1528588209
Name:ANDERSEN, JILLIAN S (AUD)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:S
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 VANCE DR STE 195
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2132
Mailing Address - Country:US
Mailing Address - Phone:303-432-3601
Mailing Address - Fax:303-432-3623
Practice Address - Street 1:7850 VANCE DR STE 195
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2132
Practice Address - Country:US
Practice Address - Phone:303-432-3601
Practice Address - Fax:303-432-3623
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO853231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000OtherN/A