Doctor Name: | MRS. JODIE M HAVENS |
NPI Number: | 1538428941 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP/L |
License Number: | 146010744 |
Business Practice Address: | 245 S 6th St Sheldon, IL - 609668309 |
Business Phone Number: | 8156442425 |
Business Fax Number: | |
Mailing Address: | 245 S 6th St, SHELDON |
State: | IL |
Postal Code: | 609668309 |
Phone Number: | 8156442425 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2012 |
NPI Last Update Date: | 05/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 146010744 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |