Burnside, Jill Marie

Burnside, Jill Marie is an individual health care provider with primary practice located at 8066 White Crane Ct , Kissimmee FL 34747-2217. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Burnside, Jill Marie can be contacted via phone (717) 580-9205.

Contact Information

Primary practice address
8066 White Crane Ct Kissimmee FL 34747-2217
Phone: (717) 580-9205
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA11556 Florida
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SL0007292 Pennsylvania

Profile Details

NPI number 1992838734
LBN Legal business name Burnside, Jill Marie
Credentials M.A., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 13th, 2007
Last updated Jul 22nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992838734 NPPES
Florida MEDICAID 013184100

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