Provider Demographics
NPI:1093390676
Name:OROZCO, JORDAN ALLYSSABETH (MS, SLP-INTERN)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:ALLYSSABETH
Last Name:OROZCO
Suffix:
Gender:F
Credentials:MS, SLP-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6763 DAKOTA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8120
Mailing Address - Country:US
Mailing Address - Phone:915-479-0009
Mailing Address - Fax:
Practice Address - Street 1:3551 RICH BEEM STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4376
Practice Address - Country:US
Practice Address - Phone:915-303-5177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist