Doctor Name: | MRS. JODI DRAKE |
NPI Number: | 1841690534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2014025188 |
Business Practice Address: | 409 E 15th St Eldon, MO - 650262533 |
Business Phone Number: | 4177733848 |
Business Fax Number: | |
Mailing Address: | 409 E 15th St, ELDON |
State: | MO |
Postal Code: | 650262533 |
Phone Number: | 4177733848 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2014 |
NPI Last Update Date: | 08/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2014025188 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |