Provider Demographics
NPI:1801454061
Name:SCHOLES, JODI (BCLMT)
Entity type:Individual
Prefix:MS
First Name:JODI
Middle Name:
Last Name:SCHOLES
Suffix:
Gender:F
Credentials:BCLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6561
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03802-6561
Mailing Address - Country:US
Mailing Address - Phone:703-220-5375
Mailing Address - Fax:
Practice Address - Street 1:110 BREWERY LN STE 402
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4890
Practice Address - Country:US
Practice Address - Phone:703-220-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019004665225700000X
NH7498225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist