Provider Demographics
NPI:1487279766
Name:SKROVAN, JODI LYNN (MA,CCC/A)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:LYNN
Last Name:SKROVAN
Suffix:
Gender:F
Credentials:MA,CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6724 SERRELL LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-8701
Mailing Address - Country:US
Mailing Address - Phone:937-707-8267
Mailing Address - Fax:
Practice Address - Street 1:110 N MAIN ST STE 350
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-3735
Practice Address - Country:US
Practice Address - Phone:937-499-8263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01091231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist