Individual
NICOLE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
6976 PROFESSIONAL PKWY E, LAKEWOOD RANCH, FL 34240
(941) 308-4641
(941) 342-6189
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
(407) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
0-18-8907
—
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
06/20/2018
Last updated
09/06/2018
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