Provider Demographics
NPI:1538783337
Name:SPRAGGINS, JORDAN TRAVIS (MA SLP)
Entity type:Individual
Prefix:MISS
First Name:JORDAN
Middle Name:TRAVIS
Last Name:SPRAGGINS
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:SKYLER
Other - Last Name:TRAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 ALDERSGATE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6620
Mailing Address - Country:US
Mailing Address - Phone:501-821-5459
Mailing Address - Fax:
Practice Address - Street 1:1900 ALDERSGATE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6620
Practice Address - Country:US
Practice Address - Phone:501-821-5459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8554235Z00000X
AR201838235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist