Individual
ASHLEY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 SHILOH HILLS DR NW, KENNESAW, GA 30144-1442
(678) 977-0006
Mailing address
260 SHILOH HILLS DR NW, KENNESAW, GA 30144-1442
(678) 977-0006
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-117569
GA
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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