| NPI | 1255632501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE B JORDAN Speech Language Pathologist 757-645-3339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202000636) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2010-11-03 |