Provider Demographics
NPI:1801044474
Name:WOHLETZ, JODI I
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:WOHLETZ
Suffix:I
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 1:21112 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-8981
Mailing Address - Country:US
Mailing Address - Phone:913-620-6911
Mailing Address - Fax:
Practice Address - Street 1:6400 GLENWOOD ST
Practice Address - Street 2:STE 205
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4016
Practice Address - Country:US
Practice Address - Phone:913-432-2900
Practice Address - Fax:913-432-2901
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist