Individual
MISS IESHA ANN JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1329 EMERALD HILL WAY, VALRICO, FL 33594-5027
(813) 485-2015
Mailing address
3608 E POWHATAN AVE, TAMPA, FL 33610-3725
(813) 485-2015
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
FL
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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