Individual
JORDAN L BOLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
804 N 7TH ST, PERRY, OK 73077-4230
(580) 216-4321
(580) 710-7008
Mailing address
804 N 7TH ST, PERRY, OK 73077-4230
(580) 216-4321
(580) 710-7008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4013
OK
Other
Enumeration date
02/16/2017
Last updated
02/16/2017
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