Childres, Jillian L

Childres, Jillian L is an individual health care provider with primary practice located at 13101 Bruce B Downs Blvd , Tampa FL 33612-3803. She recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / School is her primary health care specialty. Childres, Jillian L can be contacted via phone (813) 974-1189.

Contact Information

Primary practice address
13101 Bruce B Downs Blvd Tampa FL 33612-3803
Phone: (813) 974-1189
Fax: (813) 558-1343
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Behavioral Health & Social Service Providers / School 103TS0200X PY8272 Florida
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY8272 Florida

Profile Details

NPI number 1346449584
LBN Legal business name Childres, Jillian L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Feb 18th, 2021 - about 3 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 1346449584 NPPES
Florida Other 593P1 BLUE CROSS BLUE SHIELD

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