Individual
JEROD PAUL MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, CCC-SLP
Contact information
Practice address
19198 CHOCTAW RD, BEND, OR 97702-8961
(541) 728-3349
(888) 782-4224
Mailing address
19198 CHOCTAW RD, BEND, OR 97702-8961
(541) 728-3349
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15153
OR
Other
Enumeration date
01/05/2018
Last updated
04/21/2023
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