Kristin Marie Jordan, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Fairview, PA

NPI 1992170823 · NPPES record last updated Dec 3, 2015

Key facts

NPI
1992170823
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL012458 (PA)
Practice address
900 Manchester Rd
Fairview, PA 16415-1703
Phone
(814) 838-4822
Fax
(814) 833-8356
NPI assigned
Dec 3, 2015
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SL012458PAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL012458 PA Yes

Addresses

Primary practice location

900 Manchester Rd
Fairview, PA 16415-1703

Mailing address

1100 Shawnee Road
Lima, OH 45805
Phone (419) 999-2030

Other providers in Fairview, PA

All providers in Fairview, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.