Provider Demographics
NPI:1699936591
Name:HRANICKA, JILL M (PSYD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:HRANICKA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4823
Mailing Address - Country:US
Mailing Address - Phone:814-238-1880
Mailing Address - Fax:
Practice Address - Street 1:229 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4823
Practice Address - Country:US
Practice Address - Phone:814-238-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6023103TC0700X
PAPSO17352103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical