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NPI Code Detail

MEDICARE: JADE SYMONE REDWINE SLPA

MEDICARE:   JADE SYMONE REDWINE  SLPA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant44572TX

General Provider Information

NPI Number : 1558205260
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE SYMONE REDWINE SLPA
Provider Business Mailing Address
First Line : 1608 VATICAN LN
Second Line :
City : DALLAS
State : TX
Zip : 75224-4827
Country : US
Telephone Number : 469-274-6765
Fax Number :
Provider Business Practice Location Address
First Line : 8610 GREENVILLE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75243-7144
Country : US
Telephone Number : 469-310-1572
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2026
Last Update Date : 04/15/2026

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Directions to “ JADE SYMONE REDWINE SLPA” Practice Location

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