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Individual

LIZZETTE M. JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12104 OAKFIELD AVE, CLEVELAND, OH 44105-1929
(216) 571-0372
Mailing address
12104 OAKFIELD AVE, CLEVELAND, OH 44105-1929
(216) 571-0372

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
CDCARJ811021
OH
175T00000X
Peer Specialist
Primary
1369
OH

Other

Enumeration date
06/30/2018
Last updated
08/29/2019
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