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NPI Code Detail

MEDICARE: MRS. JILL ELIZABETH GREWAL M.S., CCC-SLP

MEDICARE: MRS. JILL ELIZABETH GREWAL M.S., CCC-SLP
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
1235Z00000XSpeech-Language PathologistSP.14092OH
2235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1619581907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JILL ELIZABETH GREWAL M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1630 MIAMI CHAPEL RD
Second Line :
City : DAYTON
State : OH
Zip : 45417-4528
Country : US
Telephone Number : 937-542-4290
Fax Number : 937-542-4291
Provider Business Practice Location Address
First Line : 1630 MIAMI CHAPEL RD
Second Line :
City : DAYTON
State : OH
Zip : 45417-4528
Country : US
Telephone Number : 937-542-4290
Fax Number : 937-542-4291
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2020
Last Update Date : 05/27/2022

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Directions to “ MRS. JILL ELIZABETH GREWAL M.S., CCC-SLP” Practice Location

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