Individual
MRS. JORDAN DORA BERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6100 N KEYSTONE AVE STE 420, INDIANAPOLIS, IN 46220-2892
(317) 296-4914
(317) 713-0177
Mailing address
5310 E 79TH ST, INDIANAPOLIS, IN 46250-1704
(317) 504-8475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008763A
IN
Other
Enumeration date
02/24/2020
Last updated
07/13/2020
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