Provider Demographics
NPI:1932516226
Name:CLARKE, JODI-ANN (MA)
Entity Type:Individual
Prefix:
First Name:JODI-ANN
Middle Name:
Last Name:CLARKE
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 1:127 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1809
Mailing Address - Country:US
Mailing Address - Phone:917-297-4951
Mailing Address - Fax:
Practice Address - Street 1:127 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1809
Practice Address - Country:US
Practice Address - Phone:917-297-4951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist