Provider Demographics
NPI:1982939443
Name:FOLDS, JASON A (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:FOLDS
Suffix:
Gender:M
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10740 N EM EN EL GROVE RD
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-7952
Mailing Address - Country:US
Mailing Address - Phone:727-729-1145
Mailing Address - Fax:
Practice Address - Street 1:10740 N EM EN EL GROVE RD
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-7952
Practice Address - Country:US
Practice Address - Phone:727-729-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist