Individual
DASIA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
224 W GOODYKOONTZ AVE, SAPULPA, OK 74066
(918) 954-3480
Mailing address
224 W GOODYKOONTZ AVE, SAPULPA, OK 74066-6468
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
09/29/2025
Last updated
10/24/2025
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