Doctor Name: | MS. JODY ELIZABETH CLOUGH |
NPI Number: | 1467641803 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | SLP-1723 |
Business Practice Address: | 700 S Main St Moscow, ID - 838433056 |
Business Phone Number: | 2088830086 |
Business Fax Number: | |
Mailing Address: | 716 Oak St, Apt 4 HOOD RIVER |
State: | OR |
Postal Code: | 970311883 |
Phone Number: | 5412311016 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2007 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP-1723 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |