Provider Demographics
NPI:1992442370
Name:MCKNIGHT, JODI (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:MCKNIGHT
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 1:5320 ADAMS AVE PKWY
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-6913
Mailing Address - Country:US
Mailing Address - Phone:801-476-7800
Mailing Address - Fax:
Practice Address - Street 1:370 W 2000 N
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:UT
Practice Address - Zip Code:84414-7267
Practice Address - Country:US
Practice Address - Phone:801-472-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist