Provider Demographics
NPI:1124229430
Name:JONES, LOURDES RAQUEL (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LOURDES
Middle Name:RAQUEL
Last Name:JONES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 W TEAKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-6397
Mailing Address - Country:US
Mailing Address - Phone:480-252-5857
Mailing Address - Fax:
Practice Address - Street 1:264 W TEAKWOOD PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-6397
Practice Address - Country:US
Practice Address - Phone:480-252-5857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP-L5426235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist