MALLORY LYNN TILLIS SLP
NPI 1124519145
Speech-Language Pathologist in Jacksonville, FL

Q: What is Mallory Tillis's NPI number?

The NPI number for Mallory Tillis is 1124519145. It was assigned to this individual provider in the NPPES registry on May 24, 2018. The provider is also known as Mallory Butler Slp.

Q: What is Mallory Tillis's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Tillis was last updated on July 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 24, 2018

6820 SOUTHPOINT PKWY STE 9, JACKSONVILLE, FL 32216(039) 888-8754 Get Directions Write a Review

NPPES record last updated: July 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 28, 2024, Dec 8, 2021, May 24, 2018 (3 updates tracked since 2018).

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About Mallory Lynn Tillis Slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY LYNN TILLIS SLP (NPI 1124519145) is an individual speech-language pathologist provider in Jacksonville, Florida, licensed in Colorado (SLP.0005885) and active in the NPI registry since May 2018.

NPPES Registry Identity

NPI1124519145

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameMALLORY LYNN TILLISCredential: SLP

Location Address6820 SOUTHPOINT PKWY STE 9Jacksonville, FL 32216-6277

Mailing Address15701 E 1st Ave Ste 106Aurora, CO 80011-9037

Phone(039) 888-8754

Sole ProprietorNo

Enumeration DateMay 24, 2018

Last NPPES UpdateJuly 28, 20243 updates tracked since enumeration

NPPES CertifiedJuly 28, 2024

✔ NPI 1124519145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

Licenses✔ Licensed in CO · SLP.0005885✔ Licensed in FL · SA14700

Definition

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

6820 SOUTHPOINT PKWY STE 9, Jacksonville, FL 32216

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Other Names 1

Former Name (1)Mallory Butler Slp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

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Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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