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General NPI Number Information
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NPI Number | 1144062696
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Entity Type | Individual
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Provider Name | CAROLINE CHRISTINE JORDAN M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 395 S SHORE DR STE 310
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City | BATTLE CREEK
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State | MI
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Zip | 49014-5466
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Country | US
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Telephone | 269-660-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 5040 COOPERS LANDING DR APT 2C
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City | KALAMAZOO
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State | MI
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Zip | 49004-6646
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Country | US
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Telephone | 269-276-6212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7101008580
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License Number State | MI
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