Individual
MARY K. JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
1952 FISCHER DR, WACONIA, MN 55387-7501
(952) 442-2191
(952) 442-6044
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13949
MN
Other
Enumeration date
07/07/2005
Last updated
01/07/2015
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