Individual
MISS GINA MICHELE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10015 OLD COLUMBIA RD, SUITE B 215, COLUMBIA, MD 21046-1703
(410) 312-7631
Mailing address
400 SYMPHONY CIR, #331, HUNT VALLEY, MD 21030-1989
(410) 771-6671
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A00176
MD
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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