Individual
JORDAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
(314) 989-8100
Mailing address
9743 GUEHRING DR, SAINT LOUIS, MO 63123-7123
(314) 443-9327
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2019021612
MO
Other
Enumeration date
08/26/2019
Last updated
08/18/2022
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