Provider Demographics
NPI:1033821053
Name:OOST, JADE BREANN (MCD,CCC-SLP)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:BREANN
Last Name:OOST
Suffix:
Gender:F
Credentials:MCD,CCC-SLP
Other - Prefix:
Other - First Name:JADE
Other - Middle Name:BREANN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD,CCC-SLP
Mailing Address - Street 1:1110 CARROLL RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450
Mailing Address - Country:US
Mailing Address - Phone:870-897-2372
Mailing Address - Fax:870-931-4457
Practice Address - Street 1:1110 CARROLL RD
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450
Practice Address - Country:US
Practice Address - Phone:870-897-2372
Practice Address - Fax:870-236-2529
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP202627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR294777721OtherBLUE CROSS BLUE SHIELD OF ARKANSAS