Individual
JORDAN MARY AMANDA CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP CCC-SLP
Contact information
Practice address
3241 NEW RENAISSANCE WAY, CHARLOTTE, NC 28208-6633
(980) 343-0049
(980) 343-0053
Mailing address
6740 EVANTON LOCH RD, CHARLOTTE, NC 28278-8010
(219) 608-4219
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11536
NC
235Z00000X
Speech-Language Pathologist
5997
SC
235Z00000X
Speech-Language Pathologist
Primary
—
NC
Other
Enumeration date
08/14/2014
Last updated
04/13/2026
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