Doctor Name: | JODI L MAYNARD |
NPI Number: | 1699922450 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA.CCC-SLP |
License Number: | 1097 |
Business Practice Address: | 1401 E 303rd St Paola, KS - 660711386 |
Business Phone Number: | 9132948040 |
Business Fax Number: | 9132948041 |
Mailing Address: | 1401 E 303rd St, PAOLA |
State: | KS |
Postal Code: | 660711386 |
Phone Number: | 9132948040 |
Fax Number: | 9132948041 |
NPI Enumeration Date: | 08/24/2008 |
NPI Last Update Date: | 08/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1097 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
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 |