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Individual
SANDRA MONIQUE JORDAN
Active
Individual
SANDRA MONIQUE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
077754-1
NY
1041C0700X
Clinical Social Worker
Primary
090746
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07200077754
—
NY
Enumeration date
10/01/2008
Last updated
11/22/2021
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