Individual
MS. SHEILA S JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMGT, CHCP, PSS
Contact information
Practice address
1017 NE MARION PL, BEND, OR 97701-3726
(541) 728-1991
Mailing address
1017 NE MARION PL, BEND, OR 97701-3726
(541) 728-1991
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000104644
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000104644
REGISTRATION NUMBER
OR
Enumeration date
03/26/2021
Last updated
03/26/2021
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