Provider Demographics
NPI:1427537968
Name:SHAFFER, JORDYN (MT-BC)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9093 RIDGEFIELD DR STE 204
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6712
Mailing Address - Country:US
Mailing Address - Phone:240-394-9399
Mailing Address - Fax:249-394-4845
Practice Address - Street 1:9093 RIDGEFIELD DR STE 204
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6712
Practice Address - Country:US
Practice Address - Phone:240-394-9399
Practice Address - Fax:249-394-4845
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist