Provider Demographics
NPI:1679446009
Name:BLUFORD, JADA ALEXIS
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:ALEXIS
Last Name:BLUFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JADA
Other - Middle Name:ALEXIS
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:960 WINDSOR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5221
Mailing Address - Country:US
Mailing Address - Phone:757-648-4040
Mailing Address - Fax:
Practice Address - Street 1:960 WINDSOR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5221
Practice Address - Country:US
Practice Address - Phone:757-648-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001661235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist