Individual
LISA L JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2175 LITTLE HORN DR, SHERIDAN, WY 82801-8820
(307) 431-1317
Mailing address
PO BOX 43, MR 10202, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
(612) 262-4258
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25291
MN
1041C0700X
Clinical Social Worker
LCSW-451
WY
Other
Enumeration date
03/21/2007
Last updated
02/21/2020
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