MEDICARE: JILL TULLMAN & ASSOCIATES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1194334169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JILL TULLMAN & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	9137 E MINERAL CIR STE 120
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-3422
Country	:	US
Telephone Number	:	303-284-4021
Fax Number	:

Provider Business Practice Location Address
First Line	:	7222 COMMERCE CENTER DR STE 255
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2632
Country	:	US
Telephone Number	:	303-284-4021
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	NICOLE WIGHT
Credential	:
Telephone Number	:	303-284-4021

Provider Enumeration Date	:	07/27/2020
Last Update Date	:	07/27/2020

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