Provider Demographics
NPI:1831507854
Name:JORDAN, RACHEL V (PHD, ATC, LAT, NASM)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:V
Last Name:JORDAN
Suffix:
Gender:
Credentials:PHD, ATC, LAT, NASM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9455 TWO HILLS CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3228
Mailing Address - Country:US
Mailing Address - Phone:443-902-7562
Mailing Address - Fax:
Practice Address - Street 1:9455 TWO HILLS CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3228
Practice Address - Country:US
Practice Address - Phone:443-902-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BOC1107020252255A2300X
FLAL32682255A2300X
VA01260013902255A2300X
DCAT230000412255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer