Individual
MRS. JODI ANN INTELICATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
(260) 483-2100
Mailing address
3320 N CLINTON ST, FORT WAYNE, IN 46805-1918
(260) 483-2100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006790A
IN
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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