Provider Demographics
NPI:1134819196
Name:WHEELER, JORDAN (SLP-A)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7362
Mailing Address - Country:US
Mailing Address - Phone:870-805-5793
Mailing Address - Fax:888-251-1746
Practice Address - Street 1:2610 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7362
Practice Address - Country:US
Practice Address - Phone:870-805-5793
Practice Address - Fax:888-251-1746
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant