Provider Demographics
NPI:1336494764
Name:STOUFFER, JODI LEIGH (MS)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LEIGH
Last Name:STOUFFER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LEIGH
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3037 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FISHERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15539-9854
Mailing Address - Country:US
Mailing Address - Phone:814-839-2839
Mailing Address - Fax:
Practice Address - Street 1:3037 VALLEY RD
Practice Address - Street 2:
Practice Address - City:FISHERTOWN
Practice Address - State:PA
Practice Address - Zip Code:15539-9854
Practice Address - Country:US
Practice Address - Phone:814-839-2839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000165L235Z00000X
VA2202007327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist