Provider Demographics
NPI:1215073432
Name:STEELE, JADA LEE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JADA
Middle Name:LEE
Last Name:STEELE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3623
Mailing Address - Country:US
Mailing Address - Phone:813-886-2373
Mailing Address - Fax:
Practice Address - Street 1:1725 E BAY DR
Practice Address - Street 2:SUITE C
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2208
Practice Address - Country:US
Practice Address - Phone:727-582-9665
Practice Address - Fax:727-582-9865
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist