Provider Demographics
NPI:1801065230
Name:PLANCHON, JODI ANN (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:ANN
Last Name:PLANCHON
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02494-1319
Mailing Address - Country:US
Mailing Address - Phone:781-726-6209
Mailing Address - Fax:781-726-6212
Practice Address - Street 1:150 WEST STREET
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-1319
Practice Address - Country:US
Practice Address - Phone:781-726-6209
Practice Address - Fax:781-726-6212
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6988235Z00000X
12061866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA73710213OtherBCBS