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General NPI Number Information
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NPI Number | 1396340345
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Entity Type | Individual
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Provider Name | TASIA STONE JORDAN SLP-A
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 53 ASH DR
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1102
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Country | US
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Telephone | 954-607-8223
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Fax |
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Provider Business Mailing Address
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Address Line | 4303 REFLECTIONS BLVD APT 201
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City | SUNRISE
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State | FL
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Zip | 33351-8231
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Country | US
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Telephone | 305-491-3574
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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 | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI4423
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License Number State | FL
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