Individual
MS. MALLORY JORDAN DANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
4815 LIBERTY AVE STE 443, PITTSBURGH, PA 15224-2156
(412) 621-2656
Mailing address
4815 LIBERTY AVE STE 443, PITTSBURGH, PA 15224-2156
(412) 621-2656
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AT006476
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15441266
CAQH
—
Enumeration date
01/06/2017
Last updated
11/17/2021
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