Jodie Manley, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

104279 Issued in TX

Practice address

4362 US Highway 259 N
Longview, TX 75605-7674

Phone

(903) 212-7716

NPI assigned

Feb 25, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519516800000",
    "number": "1447751466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 OAKRIDGE DR",
            "city": "GLADEWATER",
            "state": "TX",
            "postal_code": "756474131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4362 US HIGHWAY 259 N",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057674",
            "telephone_number": "903-212-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "JODIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-25",
        "last_updated": "2018-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Ryan Mancilla
• Geeta Gyaneshwari Mandavilli
• Venkata Amarendra Mangalagiri, MD
• Audrey N Mangwiro, M.D.
• Suganya Manivannan, MD
• Darvy Lee Mann, MD
• True Sandlin Mann, PH.D
• Athena Lynn Manning, LPC
• Gary F Mapes, DDS
• Maples Chiropractic Group, PC

• Speech-Language Pathologist in Longview, TX
• Providers in Longview, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.