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Individual

MISS DELAURA A JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5420 N HARLEM AVE, CHICAGO, IL 60656-1800
(708) 667-0790
Mailing address
4744 ROSE ST APT 2R, SCHILLER PARK, IL 60176-1541
(773) 969-2850

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/01/2024
Last updated
08/01/2024
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