Individual
GABRIELLE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1681 HICKORY LOOP, LAS CRUCES, NM 88005-6587
(575) 647-3773
Mailing address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(575) 526-6682
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2017
Last updated
06/03/2020
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