Provider Demographics
NPI:1154451011
Name:BUTTERFIELD, JOCELYN HANNAH (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:HANNAH
Last Name:BUTTERFIELD
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:MS
Other - First Name:JOCELYN
Other - Middle Name:HANNAH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:805 BROOKMEAD DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-7573
Mailing Address - Country:US
Mailing Address - Phone:636-978-4669
Mailing Address - Fax:
Practice Address - Street 1:805 BROOKMEAD DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7573
Practice Address - Country:US
Practice Address - Phone:636-978-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005024102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist