Provider Demographics
NPI:1447726914
Name:MARLER, JILLIAN APRIL (SLP)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:APRIL
Last Name:MARLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6104 MAPLE GROVE WAY
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-6467
Mailing Address - Country:US
Mailing Address - Phone:765-251-1567
Mailing Address - Fax:
Practice Address - Street 1:6104 MAPLE GROVE WAY
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-6467
Practice Address - Country:US
Practice Address - Phone:765-251-1567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005821A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer