Individual
LAVON JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2128 UNIVERSITY PL, DAYTON, OH 45406-5965
(937) 305-0016
Mailing address
2128 UNIVERSITY PL, DAYTON, OH 45406-5965
(937) 305-0016
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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