Individual
MRS. JODIE M HAVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP/L
Contact information
Practice address
245 S 6TH ST, SHELDON, IL 60966-8309
(815) 644-2425
Mailing address
245 S 6TH ST, SHELDON, IL 60966-8309
(815) 644-2425
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
146010744
IL
235Z00000X
Speech-Language Pathologist
Primary
146010744
IL
Other
Enumeration date
05/07/2012
Last updated
05/07/2012
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