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

LicenseStateTypeSpecialty
2019019629MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Hannibal, MO

All providers in Hannibal, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.