| Doctor Name: | TAMMARA ANN JORDAN |
| NPI Number: | 1104979731 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S.,CCC-SLP |
| License Number: | S2203 |
| Business Practice Address: | 1605 S 28th Ave Hattiesburg, MS - 394023110 |
| Business Phone Number: | 6015793310 |
| Business Fax Number: | 6012640231 |
| Mailing Address: | 415 S 28th Ave, HATTIESBURG |
| State: | MS |
| Postal Code: | 394017246 |
| Phone Number: | 6015795463 |
| Fax Number: | 6015795240 |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 01/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S2203 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |