MEDICARE: VICTORIA LYNN JORDAN M.A., CF-SLP

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
1	235Z00000X	Speech-Language Pathologist	02398L	MD

General Provider Information

NPI Number	:	1427725373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA LYNN JORDAN M.A., CF-SLP

Provider Business Mailing Address
First Line	:	850 HUNGERFORD DR
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-1718
Country	:	US
Telephone Number	:	240-288-5599
Fax Number	:

Provider Business Practice Location Address
First Line	:	631 SILVER SPRING AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4607
Country	:	US
Telephone Number	:	240-288-5599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2021
Last Update Date	:	08/27/2021

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