Provider Demographics
NPI:1265009757
Name:DUNLAP, JORDAN ROSE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:ROSE
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-2253
Mailing Address - Country:US
Mailing Address - Phone:304-551-2734
Mailing Address - Fax:
Practice Address - Street 1:312 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-2253
Practice Address - Country:US
Practice Address - Phone:304-551-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist