Individual
CHERYL BORDEN-JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
117 E LAKE AVE, SUITE D, AUBURNDALE, FL 33823-3437
(863) 551-3300
(863) 551-3301
Mailing address
PO BOX 1057, LAKE ALFRED, FL 33850-1057
(863) 551-3300
(863) 551-3301
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-01-0480
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
675822396
MEDWAIVER
FL
01
—
675822398
MEDWAIVER
FL
Enumeration date
05/19/2009
Last updated
05/19/2009
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