Provider Demographics
NPI:1689554958
Name:WOODELL, JEANNA LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JEANNA
Middle Name:LYNN
Last Name:WOODELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 RARITAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-4212
Mailing Address - Country:US
Mailing Address - Phone:908-442-3908
Mailing Address - Fax:
Practice Address - Street 1:1000 HERRONTOWN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-7716
Practice Address - Country:US
Practice Address - Phone:732-617-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01332000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist