Individual
DANIELLIE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8143 VERMONT AVE # 320, WARREN, MI 48093-7217
(313) 575-3634
Mailing address
8143 VERMONT AVE, WARREN, MI 48093-7217
(313) 575-3634
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6851099084
MI
Other
Enumeration date
08/17/2015
Last updated
05/07/2025
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