Provider Demographics
NPI:1043002314
Name:ROEDER, JORDAN PAIGE
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:PAIGE
Last Name:ROEDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7656 TOWNSHIP ROAD 94
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-9678
Mailing Address - Country:US
Mailing Address - Phone:419-422-2542
Mailing Address - Fax:
Practice Address - Street 1:2820 GREENACRE DR
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4157
Practice Address - Country:US
Practice Address - Phone:419-422-2542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20253011-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist