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Individual

ASHLEY JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
225 CASTELLANO DR, SWANSEA, IL 62226-3027
(618) 222-2571
Mailing address
4686 DAWS CT UNIT A, SCOTT AFB, IL 62225-6831

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2016007741
MO
225X00000X
Occupational Therapist
5201008933
MI
225X00000X
Occupational Therapist
Primary
56.011469
IL

Other

Enumeration date
03/23/2016
Last updated
03/23/2016
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