Individual
JORDAN LEE WHEALDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
6417 W IRVING PARK RD, CHICAGO, IL 60634-2437
(773) 777-7112
Mailing address
1101 W COLUMBIA AVE APT 202, CHICAGO, IL 60626-4581
(937) 728-0225
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150104805
IL
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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