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General NPI Number Information
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NPI Number | 1497386627
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Entity Type | Individual
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Provider Name | JORDYN R HAZELRIG MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2450 ATLANTA HWY STE 204
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City | CUMMING
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State | GA
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Zip | 30040-1251
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Country | US
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Telephone | 770-285-7892
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Fax |
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Provider Business Mailing Address
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Address Line | 334 BROOKWOOD DR W
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City | DAWSONVILLE
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State | GA
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Zip | 30534-7405
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Country | US
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Telephone | 616-443-9598
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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 | SLP009959
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License Number State | GA
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