Provider Demographics
NPI:1326268046
Name:YODER, JESSICA DAWN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:DAWN
Last Name:YODER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16666-9148
Mailing Address - Country:US
Mailing Address - Phone:814-343-2573
Mailing Address - Fax:
Practice Address - Street 1:1964 LOGAN RD
Practice Address - Street 2:
Practice Address - City:OSCEOLA MILLS
Practice Address - State:PA
Practice Address - Zip Code:16666-9148
Practice Address - Country:US
Practice Address - Phone:814-343-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist