Provider Demographics
NPI:1659411403
Name:PASKET, RANDI JONES (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:JONES
Last Name:PASKET
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:14444 BEACH BLVD
Mailing Address - Street 2:STE 500
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2079
Mailing Address - Country:US
Mailing Address - Phone:904-858-7512
Mailing Address - Fax:904-858-7540
Practice Address - Street 1:14444 BEACH BLVD
Practice Address - Street 2:STE 500
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-2079
Practice Address - Country:US
Practice Address - Phone:904-858-7512
Practice Address - Fax:904-858-7540
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist