Provider Demographics
NPI:1942676135
Name:SPAULDING, JORDANNA
Entity Type:Individual
Prefix:
First Name:JORDANNA
Middle Name:
Last Name:SPAULDING
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 1:34 CHOCTAW TRL
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2205
Mailing Address - Country:US
Mailing Address - Phone:201-602-7767
Mailing Address - Fax:
Practice Address - Street 1:34 CHOCTAW TRL
Practice Address - Street 2:
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2205
Practice Address - Country:US
Practice Address - Phone:201-602-7767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst