Basic Information
| Provider Information | |||||||||
| NPI: | 1851790422 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHIRDON | ||||||||
| FirstName: | JEANNE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 48 SALEM AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288043338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162569628 | ||||||||
| FaxNumber: | 8438846481 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 TRADITION CIR | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294667200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436547945 | ||||||||
| FaxNumber: | 8438846481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2014 | ||||||||
| LastUpdateDate: | 08/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 5475 | SC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.