Provider Demographics
NPI:1588863138
Name:JORDAN, TOUPAZER (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TOUPAZER
Middle Name:
Last Name:JORDAN
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 1:15516 TIERRA DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1268
Mailing Address - Country:US
Mailing Address - Phone:703-725-9290
Mailing Address - Fax:
Practice Address - Street 1:15516 TIERRA DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1268
Practice Address - Country:US
Practice Address - Phone:240-864-6000
Practice Address - Fax:240-864-6049
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist