MEDICARE: JODI MCNEIL CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP9218	AZ

General Provider Information

NPI Number	:	1700368446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI MCNEIL CCC-SLP

Provider Business Mailing Address
First Line	:	24029 N 76TH PL
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85255-6158
Country	:	US
Telephone Number	:	602-290-0676
Fax Number	:

Provider Business Practice Location Address
First Line	:	4700 S MCCLINTOCK DR STE 135
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-7375
Country	:	US
Telephone Number	:	480-719-5564
Fax Number	:	480-347-0853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2018
Last Update Date	:	08/29/2018

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Directions to “ JODI MCNEIL CCC-SLP” Practice Location

Language	Start Address	Practice Location

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