Individual
MS. JORDAN LORRAINE PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
905 FRIEDBERG CHURCH RD, WINSTON SALEM, NC 27127-9803
(336) 251-1180
Mailing address
200 FOREST PARK CIR APT 228, WINSTON SALEM, NC 27127-5076
(336) 710-9831
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NC
Other
Enumeration date
12/21/2021
Last updated
12/21/2021
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