Individual
CANDACE N JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
250 UNIVERSITY DR, MONTICELLO, AR 71655-8891
(870) 367-6893
Mailing address
416 BURTON RD, MONTICELLO, AR 71655-9657
(870) 723-9873
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2296
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257815
NBCOT
AR
Enumeration date
07/23/2013
Last updated
06/14/2022
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