Provider Demographics
NPI:1619514486
Name:FOLDES, JORDAN RICE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:RICE
Last Name:FOLDES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:573 HALLORAN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-4469
Mailing Address - Country:US
Mailing Address - Phone:310-422-2049
Mailing Address - Fax:
Practice Address - Street 1:573 HALLORAN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-4469
Practice Address - Country:US
Practice Address - Phone:310-422-2049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2636235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist