Provider Demographics
NPI:1861577363
Name:CHANDLER, JILL KAY (MS-CCC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:KAY
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MS-CCC
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:K
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8431 FREDERICKSBURG RD
Mailing Address - Street 2:FL 1
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3729
Mailing Address - Country:US
Mailing Address - Phone:210-450-4621
Mailing Address - Fax:
Practice Address - Street 1:8300 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3931
Practice Address - Country:US
Practice Address - Phone:210-450-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist