Provider Demographics
NPI:1780932806
Name:PAUL, JODY LITWIN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:LITWIN
Last Name:PAUL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SUNNYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-4204
Mailing Address - Country:US
Mailing Address - Phone:917-533-3838
Mailing Address - Fax:
Practice Address - Street 1:25 SUNNYWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-4204
Practice Address - Country:US
Practice Address - Phone:917-533-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00643900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist