Individual
JORDAN KELSEY MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
5 REMINGTON CV, LITTLE ROCK, AR 72204-8274
(501) 850-8788
Mailing address
5 REMINGTON CV, LITTLE ROCK, AR 72204-8274
(501) 850-8788
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
P9191
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222651721
—
AR
Enumeration date
11/12/2014
Last updated
02/10/2020
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