Individual
JORDAN DAVID PANCHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14765 W MOUNTAIN VIEW BLVD STE 107, SURPRISE, AZ 85374-2704
(602) 649-0245
Mailing address
17617 W VOLTAIRE ST, SURPRISE, AZ 85388-5058
(480) 329-7188
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
—
AZ
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/19/2025
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