Provider Demographics
NPI:1548717200
Name:PURIFOY, JORDAN (RBT)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:PURIFOY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:PATRICE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:759 E NORTH 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3830
Mailing Address - Country:US
Mailing Address - Phone:325-829-9188
Mailing Address - Fax:
Practice Address - Street 1:759 E NORTH 13TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3830
Practice Address - Country:US
Practice Address - Phone:325-829-9188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist