Provider Demographics
NPI:1588967756
Name:CASIPLE, JILL ALEXANDRA (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ALEXANDRA
Last Name:CASIPLE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2529 SILVER SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-6647
Mailing Address - Country:US
Mailing Address - Phone:904-821-7616
Mailing Address - Fax:
Practice Address - Street 1:2529 SILVER SPRINGS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-6647
Practice Address - Country:US
Practice Address - Phone:904-821-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist