Jodi Niehoff, MA, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Hannibal, MO
NPI 1497300586 · NPPES record last updated Nov 30, 2020
Key facts
- NPI
- 1497300586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2019019629 (MO)
- Practice address
- 150 Medical Dr
Hannibal, MO 63401-6877 - Phone
- (573) 721-4033
- NPI assigned
- Aug 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019019629 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2019019629 | MO | Yes |
Addresses
Primary practice location
150 Medical Dr
Hannibal, MO 63401-6877
Mailing address
1190 Old Cap Au Gris Rd
Troy, MO 63379-2300
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All providers in Hannibal, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.