Individual
ELYSE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
945 N ADAMS ST STE 7, PAPILLION, NE 68046-3111
(402) 916-4539
Mailing address
10412 PACIFIC ST APT B392, OMAHA, NE 68114-4785
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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