# JORDAN M PATAK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1427607209
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | COND.20191212-SP | OH | Yes |

## Other

- **Enumeration date:** 09/05/2019
- **Last updated:** 04/20/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0406425 | — | OH |
| 01 | — | AB7360731 | MEDICARE PIN | OH |