Provider Demographics
NPI:1154502755
Name:TOMLINSON, JODIE LYNN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:LYNN
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15841 GATESHEAD DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-5035
Mailing Address - Country:US
Mailing Address - Phone:317-507-8469
Mailing Address - Fax:317-663-3224
Practice Address - Street 1:15841 GATESHEAD DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-5035
Practice Address - Country:US
Practice Address - Phone:317-507-8469
Practice Address - Fax:317-663-3224
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2007-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002597A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist