Jordan, Theresa

Jordan, Theresa is an individual health care provider with primary practice located at 6035 Fairview Rd , Charlotte NC 28210-3256. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter, Speech, Language and Hearing Service Providers / Audiologist. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Jordan, Theresa can be contacted via phone (704) 295-3300.

Contact Information

Primary practice address
6035 Fairview Rd Charlotte NC 28210-3256
Phone: (704) 295-3300
Fax: (704) 295-3468
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 667 North Carolina
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 2218 North Carolina

Profile Details

NPI number 1366614505
LBN Legal business name Jordan, Theresa
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2008
Last updated Mar 16th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366614505 NPPES
South Carolina Other 30109414 SELECT HEALTH
South Carolina MEDICAID SAN010 SELECT HEALTH
South Carolina Other 9890230 SELECT HEALTH
South Carolina Other 6335254 SELECT HEALTH
South Carolina Other 16271 SELECT HEALTH
South Carolina MEDICAID 7413304 SELECT HEALTH
South Carolina Other P01044553 SELECT HEALTH
South Carolina Other 879963 SELECT HEALTH

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