Provider Demographics
NPI:1962953398
Name:GILLIN, JILL E
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:E
Last Name:GILLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DUNCAN LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1601
Mailing Address - Country:US
Mailing Address - Phone:610-247-2415
Mailing Address - Fax:
Practice Address - Street 1:37 DUNCAN LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-1601
Practice Address - Country:US
Practice Address - Phone:610-247-2415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool