Provider Demographics
NPI:1346432234
Name:JEOFFROY, MARIE-JUDE NATALIE
Entity Type:Individual
Prefix:
First Name:MARIE-JUDE
Middle Name:NATALIE
Last Name:JEOFFROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3374 CEDAR SPRINGS PL
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-6554
Mailing Address - Country:US
Mailing Address - Phone:407-963-5336
Mailing Address - Fax:407-971-9698
Practice Address - Street 1:561 E MITCHELL HAMMOCK RD
Practice Address - Street 2:SUITE 400
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-5526
Practice Address - Country:US
Practice Address - Phone:407-810-2225
Practice Address - Fax:407-971-9698
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7856235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist