Provider Demographics
NPI:1275769085
Name:POLLARD, JOLIE SUZANNE (MS,CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOLIE
Middle Name:SUZANNE
Last Name:POLLARD
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 1:1516 ENGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-3234
Mailing Address - Country:US
Mailing Address - Phone:432-362-8348
Mailing Address - Fax:
Practice Address - Street 1:808 TOWER DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4239
Practice Address - Country:US
Practice Address - Phone:432-335-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist