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Individual

JAYLEN JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CTRS

Contact information

Practice address
6900 N PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
10085 MALIBU CREEK CT UNIT 101, LAS VEGAS, NV 89183-3955

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
225800000X
Recreation Therapist
Primary

Other

Enumeration date
03/27/2019
Last updated
11/30/2020
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