Provider Demographics
NPI:1396356838
Name:COLLIER, JORDAN (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:COLLIER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:AR
Mailing Address - Zip Code:72160-6983
Mailing Address - Country:US
Mailing Address - Phone:870-509-1540
Mailing Address - Fax:
Practice Address - Street 1:5905 FOREST PL STE 230
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-5265
Practice Address - Country:US
Practice Address - Phone:501-367-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPENDING235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist