Provider Demographics
NPI:1255691663
Name:STEIMLOSK, JODI LYNN (MA)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:LYNN
Last Name:STEIMLOSK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:JODI
Other - Middle Name:LYNN
Other - Last Name:OLMSTEAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2814 S US HIGHWAY 1 STE D4
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-8110
Mailing Address - Country:US
Mailing Address - Phone:772-489-4726
Mailing Address - Fax:
Practice Address - Street 1:2814 S US HIGHWAY 1 STE D4
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-8110
Practice Address - Country:US
Practice Address - Phone:772-489-4726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor