Provider Demographics
NPI:1710131107
Name:SCHNIDER, JODI M (MA)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:M
Last Name:SCHNIDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W CHARISH ST
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-2055
Mailing Address - Country:US
Mailing Address - Phone:605-498-1288
Mailing Address - Fax:
Practice Address - Street 1:200 W CHARISH ST
Practice Address - Street 2:
Practice Address - City:TEA
Practice Address - State:SD
Practice Address - Zip Code:57064-2055
Practice Address - Country:US
Practice Address - Phone:605-498-1288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5967602235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist