Provider Demographics
NPI:1376119891
Name:HANLEY, JORDIN GABRIELLE (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:JORDIN
Middle Name:GABRIELLE
Last Name:HANLEY
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6816 DAKOTA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-8114
Mailing Address - Country:US
Mailing Address - Phone:915-346-3201
Mailing Address - Fax:
Practice Address - Street 1:3118 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2503
Practice Address - Country:US
Practice Address - Phone:915-703-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist