Individual
MS. JODIE ELIZABETH LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1085 VAN VOORHIS RD, SUITE 200, MORGANTOWN, WV 26505-3497
(304) 599-9250
(304) 599-9254
Mailing address
889 RIVERVIEW DR, MORGANTOWN, WV 26505-4631
(304) 599-2485
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0624
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9400050-0000
—
WV
Enumeration date
10/10/2006
Last updated
07/08/2007
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