Individual
JORDAN LIDDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 NW 66TH ST STE 925, OKLAHOMA CITY, OK 73116-8227
(405) 286-3749
(405) 300-0373
Mailing address
200 NW 66TH ST STE 925, OKLAHOMA CITY, OK 73116-8227
(405) 286-3749
(405) 300-0373
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
Primary
375
OK
235Z00000X
Speech-Language Pathologist
375
OK
Other
Enumeration date
11/10/2021
Last updated
09/12/2024
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