Individual
JORDAN MENEFEE CHEVAKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2600 N MAYFAIR RD STE 650, WAUWATOSA, WI 53226-1322
(414) 771-9304
Mailing address
2600 N MAYFAIR RD STE 650, WAUWATOSA, WI 53226-1322
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4127-226
WI
101YP2500X
Professional Counselor
Primary
8358-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100188492
—
WI
Enumeration date
10/26/2018
Last updated
02/23/2022
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