Jordan Dana Fernekees, CF-SLP

Individual provider Active NPI Speech-Language Pathologist · Dover, DE

NPI 1194340927 · NPPES record last updated Jun 8, 2020

Key facts

NPI
1194340927
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
O4-0000666 (DE)
Practice address
541 S Red Haven LN
Dover, DE 19901-6483
Phone
(302) 674-3350
Fax
(928) 752-3350
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
O4-0000666DEMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X O4-0000666 DE Yes

Addresses

Primary practice location

541 S Red Haven LN
Dover, DE 19901-6483

Mailing address

541 S Red Haven LN
Dover, DE 19901-6483
Phone (302) 674-3350

Other providers in Dover, DE

All providers in Dover, DE · Speech-Language Pathologist in Delaware

Sources for this page

Verify at the official NPI Registry.