Most Relevant Information
Provider Data
| NPI Number: | 1003402447 |
| Provider Name: | JAZMINE GORDON CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/20/2020 |
| Last Updated: | 12/20/2020 |
Provider Practice Location
7538 ELMWOOD AVE
PHILADELPHIA
PA
191531332
Practice Location Phone/Fax
| Phone: | 2154355281 |
| Fax: |
Provider Mailing Location
7538 ELMWOOD AVE
PHILADELPHIA
PA
191531332
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |