Most Relevant Information
Provider Data
| NPI Number: | 1003579442 |
| Provider Name: | JESSICA JAYLYN JORDAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/21/2021 |
| Last Updated: | 10/21/2021 |
Provider Practice Location
51145 NICOLETTE DR
CHESTERFIELD
MI
480474585
Practice Location Phone/Fax
| Phone: | 5862289991 |
| Fax: |
Provider Mailing Location
51145 NICOLETTE DR
CHESTERFIELD
MI
480474585
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |