Provider Demographics
NPI:1104155936
Name:EDDY, JODY LYN (MS)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:LYN
Last Name:EDDY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PETER CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1224
Mailing Address - Country:US
Mailing Address - Phone:610-255-5808
Mailing Address - Fax:
Practice Address - Street 1:7 PETER CHRISTOPHER DR
Practice Address - Street 2:
Practice Address - City:LANDENBERG
Practice Address - State:PA
Practice Address - Zip Code:19350-1224
Practice Address - Country:US
Practice Address - Phone:610-255-5808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE020000078231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist