Provider Demographics
NPI:1578207205
Name:ROBINSON, JORDAN AALIYAH
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:AALIYAH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3816 DODSON CHAPEL RD APT 314
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-3781
Mailing Address - Country:US
Mailing Address - Phone:256-577-6778
Mailing Address - Fax:
Practice Address - Street 1:368 QUARRY LOOP RD
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-7206
Practice Address - Country:US
Practice Address - Phone:615-443-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist