Provider Demographics
NPI:1477039576
Name:COHEN, JODI (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:COHEN
Other - Last Name:WALDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4572 S HAGADORN RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5385
Mailing Address - Country:US
Mailing Address - Phone:517-220-4974
Mailing Address - Fax:517-220-4974
Practice Address - Street 1:4572 S HAGADORN RD STE 2A
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5385
Practice Address - Country:US
Practice Address - Phone:517-220-4974
Practice Address - Fax:517-220-4974
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist