Provider Demographics
NPI:1477887909
Name:JORDAN, KAREN SUE (OTR/L, C/LT, C/NDT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:OTR/L, C/LT, C/NDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 AUTUMN GOLD DR
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1500
Mailing Address - Country:US
Mailing Address - Phone:443-306-8892
Mailing Address - Fax:
Practice Address - Street 1:1004 AUTUMN GOLD DR
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1500
Practice Address - Country:US
Practice Address - Phone:443-306-8892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1374225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation