Provider Demographics
NPI:1568963742
Name:ARMSTRONG, JODI NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:NICOLE
Last Name:ARMSTRONG
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 1:3306 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-5232
Mailing Address - Country:US
Mailing Address - Phone:217-369-1119
Mailing Address - Fax:
Practice Address - Street 1:400 N SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:VILLA GROVE
Practice Address - State:IL
Practice Address - Zip Code:61956-9771
Practice Address - Country:US
Practice Address - Phone:217-832-2261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1837439235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist