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General NPI Number Information
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NPI Number | 1215712617
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Entity Type | Individual
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Provider Name | JORDAN ELIZABETH MACNEIL
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Gender | Female
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 3000 NE 108TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64156-6314
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Country | US
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Telephone | 816-321-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 NW 38TH ST APT 307
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City | KANSAS CITY
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State | MO
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Zip | 64116-4636
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Country | US
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Telephone | 310-697-9703
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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 | 3922
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2023032457
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License Number State | MO
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