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General NPI Number Information
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NPI Number | 1154678761
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Entity Type | Individual
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Provider Name | CHELSEA JORDAN
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Gender | Female
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 1710 NYS RTE 13
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City | CORTLAND
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State | NY
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Zip | 13045-9618
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Country | US
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Telephone | 607-758-5241
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 NYS RTE 13
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City | CORTLAND
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State | NY
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Zip | 13045-9618
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Country | US
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Telephone | 607-758-5241
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | TOC102501
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT3886
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 024708
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License Number State | NY
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