Provider Demographics
NPI:1255601480
Name:MCLEOD, DACIA JORDAN (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DACIA
Middle Name:JORDAN
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S ELM ST APT 201
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2777
Mailing Address - Country:US
Mailing Address - Phone:540-809-2925
Mailing Address - Fax:
Practice Address - Street 1:360 S ELM ST APT 201
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2777
Practice Address - Country:US
Practice Address - Phone:540-809-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist