Provider Demographics
NPI:1720116999
Name:FRANTZ, JODI (MACCC-S)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:MACCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MURDOCK DR
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901-3436
Mailing Address - Country:US
Mailing Address - Phone:304-640-3374
Mailing Address - Fax:
Practice Address - Street 1:1019 WETHERSFIELD XING
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-8719
Practice Address - Country:US
Practice Address - Phone:304-345-6313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0835235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist