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NPI Code Detail

MEDICARE: HOLLY MARIA JORDAN MSR, CCC-SLP

MEDICARE: HOLLY MARIA JORDAN MSR, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP006417GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SLP006417OTHERGASLP STATE BOARD

General Provider Information

NPI Number : 1972777258
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY MARIA JORDAN MSR, CCC-SLP
Provider Business Mailing Address
First Line : 6 RIVER WALK
Second Line :
City : SAVANNAH
State : GA
Zip : 31410-1563
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 351 WILMINGTON ISLAND RD
Second Line :
City : SAVANNAH
State : GA
Zip : 31410-3851
Country : US
Telephone Number : 912-898-9711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2008
Last Update Date : 04/17/2008

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Directions to “ HOLLY MARIA JORDAN MSR, CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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