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NPI Code Detail

MEDICARE: JILLIAN MARZEL WALSH

MEDICARE: JILLIAN MARZEL WALSH
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
1224ZF0002XFeeding, Eating & Swallowing Occupational Therapy Assistant32002180AIN

General Provider Information

NPI Number : 1336884998
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN MARZEL WALSH
Provider Business Mailing Address
First Line : 9869 GARDEN WAY
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-0199
Country : US
Telephone Number : 708-828-2762
Fax Number :
Provider Business Practice Location Address
First Line : 10700 PARK PL
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-8666
Country : US
Telephone Number : 219-247-6459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2022
Last Update Date : 09/20/2023

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Directions to “ JILLIAN MARZEL WALSH ” Practice Location

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