Individual
MRS. SAMANTHA NICHOLS JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1370 CENTER DR STE 205, DUNWOODY, GA 30338-4132
(678) 360-1742
Mailing address
490 CREEKWOOD DR, MARIETTA, GA 30068-3202
(678) 360-1742
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009525
GA
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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