Provider Demographics
NPI:1558861914
Name:HILL, JESSICA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9150 W INDIAN SCHOOL RD STE 130
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-2388
Mailing Address - Country:US
Mailing Address - Phone:480-787-5387
Mailing Address - Fax:623-232-3250
Practice Address - Street 1:1313 E OSBORN RD STE B-240
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5678
Practice Address - Country:US
Practice Address - Phone:480-787-5387
Practice Address - Fax:888-854-5861
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZSLP11245235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ185980Medicaid