Individual
JORDAN ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 RAINTREE RD STE C, CHESAPEAKE, VA 23321-3749
(757) 292-4162
Mailing address
4020 RAINTREE RD STE C, CHESAPEAKE, VA 23321-3749
(757) 292-4162
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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