Individual
KEDERAH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 N I 10 SERVICE RD W, METAIRIE, LA 70006-6713
(630) 631-4193
Mailing address
7000 PRESS DR APT 303, NEW ORLEANS, LA 70126-1069
(630) 631-4193
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
10/11/2021
Last updated
10/11/2021
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