Provider Demographics
NPI:1609609379
Name:JAROLD, LILLIAN (SLP)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:JAROLD
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 1:226 BRONX AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15229-2707
Mailing Address - Country:US
Mailing Address - Phone:412-523-7796
Mailing Address - Fax:
Practice Address - Street 1:100 S JACKSON AVE # A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-3428
Practice Address - Country:US
Practice Address - Phone:412-608-3334
Practice Address - Fax:412-460-8334
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL017207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist