Individual
MISS JORDAN RAE KAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP
Contact information
Practice address
519 S SIMS ST, BAINBRIDGE, GA 39819-4159
(229) 220-1890
Mailing address
519 S SIMS ST, BAINBRIDGE, GA 39819-4159
(229) 220-1890
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
4939
TN
235Z00000X
Speech-Language Pathologist
Primary
SLP008510
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003145576D
—
GA
Enumeration date
09/25/2013
Last updated
10/20/2018
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