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General NPI Number Information
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NPI Number | 1629530324
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Entity Type | Individual
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Provider Name | MINJA DOJCILOVIC JORDAN MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 04/30/2023
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Provider Practice Location Address
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Address Line | 399 9TH ST N STE 102
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City | NAPLES
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State | FL
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Zip | 34102-5820
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Country | US
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Telephone | 239-624-1614
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Fax |
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Provider Business Mailing Address
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Address Line | 10123 SWEETGRASS CIR UNIT 405
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City | NAPLES
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State | FL
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Zip | 34104-0899
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Country | US
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Telephone | 786-479-3940
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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 | SL015078
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License Number State | PA
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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 | 18533
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License Number State | FL
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