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Individual
JORDAN VINCENT
Active
Individual
JORDAN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.I.S.W
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1600082
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154357721
NATIONAL PROVIDER IDENTIFIER
—
05
—
2871441
—
OH
Enumeration date
06/24/2016
Last updated
06/24/2016
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