Individual
JESSICA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 SUNNY CROFT LN, FAIRMONT, WV 26554-8882
(304) 657-0895
Mailing address
26 SUNNY CROFT LN, FAIRMONT, WV 26554-8882
(304) 657-0895
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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