Provider Demographics
NPI:1649512609
Name:FOLTZ, JOLYN
Entity type:Individual
Prefix:
First Name:JOLYN
Middle Name:
Last Name:FOLTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOLYN
Other - Middle Name:
Other - Last Name:REINHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 MARGIN RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-9105
Mailing Address - Country:US
Mailing Address - Phone:717-269-5494
Mailing Address - Fax:
Practice Address - Street 1:520 MARGIN RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-9105
Practice Address - Country:US
Practice Address - Phone:717-269-5494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010474235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist