Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mallory Lynn Tillis, SLP

Individual provider Speech-Language Pathologist · NPI 1124519145

Mallory Lynn Tillis, SLP is a Speech-Language Pathologist in Jacksonville, Florida. Licensed in Colorado and Florida. Registered with an NPI since 2018.

Licensed in
CO, FL
In the registry since
2018
Specialties on file
2
What do these letters mean?
SLP — Speech-Language Pathologist
Treats speech, language and swallowing disorders.

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Practice location Address checks out

6820 Southpoint Pkwy Ste 9
Jacksonville, FL 32216-6277
Phone: (039) 888-8754
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP.0005885 (CO)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence SA14700 (FL)

Record details

NPI number1124519145
Entity typeIndividual (Type 1)
GenderFemale
Credentials SLP
Sole proprietorNo
NPI enumeratedMay 24, 2018
Last updated in NPPESJuly 28, 2024
Certification dateJuly 28, 2024

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