Provider Demographics
NPI:1710252853
Name:DAVIS-LABADIE, JODI SUE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:SUE
Last Name:DAVIS-LABADIE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 MONICO VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-2005
Mailing Address - Country:US
Mailing Address - Phone:702-286-2398
Mailing Address - Fax:
Practice Address - Street 1:5552 S FORT APACHE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7694
Practice Address - Country:US
Practice Address - Phone:702-641-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-1005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist