Provider Demographics
NPI:1932380680
Name:JORDAN, EMILY HRDINA (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:HRDINA
Last Name:JORDAN
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 1:8027 SUNDANCE CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5919
Mailing Address - Country:US
Mailing Address - Phone:919-265-4745
Mailing Address - Fax:
Practice Address - Street 1:8027 SUNDANCE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5919
Practice Address - Country:US
Practice Address - Phone:919-265-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7978235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412943Medicaid