Individual
AMY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N2767 SHADY ACRE DR, NEW LONDON, WI 54961-9136
(920) 982-0147
Mailing address
N2767 SHADY ACRE DR, NEW LONDON, WI 54961-9136
(920) 982-0147
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
01/15/2022
Last updated
01/15/2022
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