Provider Demographics
NPI:1700426327
Name:SLOAN HIGGINS, JORDAN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:SLOAN HIGGINS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 DYLAN HEATH CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-2058
Mailing Address - Country:US
Mailing Address - Phone:347-899-7883
Mailing Address - Fax:
Practice Address - Street 1:11030 RAVEN RIDGE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8511
Practice Address - Country:US
Practice Address - Phone:347-899-7883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-11
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029318-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist