Individual
JORDYN J-M HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(312) 733-0883
Mailing address
638 1/2 W CORNELIA AVE APT 3E, CHICAGO, IL 60657-2510
(831) 854-7524
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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