National Provider Identifier

Jill Pedersen, MA, CCC-SLP

Jill Pedersen, MA, CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Lockport, NY and a listed phone number of (626) 260-5450.

NPI 1619533866Lockport, NYSpeech-Language Pathologist

Profile Overview

NPI
1619533866
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
May 14, 2019
Last Updated
May 14, 2019

Practice Location

  • 6395 Old Niagara RD
  • Lockport, NY 14094-1421

Phone: (626) 260-5450

Mailing Address

  • 8289 Old Post RD E
  • East Amherst, NY 14051-1584

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1619533866
Entity Type
Individual
Last Name
Pedersen
First Name
Jill
Credential
MA, CCC-SLP
Mailing Street Address
8289 Old Post RD E
Mailing City
East Amherst
Mailing State
NY
Mailing ZIP Code
14051-1584
Mailing Country
US
Mailing Phone
(626) 260-5450
Practice Street Address
6395 Old Niagara RD
Practice City
Lockport
Practice State
NY
Practice ZIP Code
14094-1421
Practice Country
US
Practice Phone
(626) 260-5450
Enumeration Date
May 14, 2019
Last Updated
May 14, 2019
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)