Individual
MARVEL JORDAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 222-1816
(651) 602-7517
Mailing address
1314 SKILLMAN AVE W, ROSEVILLE, MN 55113-5942
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5833
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141949
UCARE
MN
01
—
53M31JO
BCBS
MN
01
—
6269866
MEDICA
MN
01
—
HP30945
HEALTH PARTNERS
MN
Enumeration date
03/27/2006
Last updated
07/08/2007
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