Individual
TIFFANY K JOURDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 398-8080
Mailing address
PO BOX 6883, CHAMPAIGN, IL 61826-6883
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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