Provider Demographics
NPI:1225181159
Name:NAEGER, JODI M (MA,CCC/SLP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:M
Last Name:NAEGER
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15994 HERZOG DR
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-8930
Mailing Address - Country:US
Mailing Address - Phone:573-483-2127
Mailing Address - Fax:
Practice Address - Street 1:6279 HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:BLOOMSDALE
Practice Address - State:MO
Practice Address - Zip Code:63627-8904
Practice Address - Country:US
Practice Address - Phone:573-883-4500
Practice Address - Fax:573-483-3535
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004012815235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist