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Individual

JORDAN NICOLE BEACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1500 N CLYBOURN AVE UNIT C105, CHICAGO, IL 60610-2295
(312) 242-1665
Mailing address
34755 COUNTY ROAD 10, KEENESBURG, CO 80643-8526
(970) 381-2869

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78117
CO
106E00000X
Assistant Behavior Analyst
A.B.61477567
WA
106S00000X
Behavior Technician
CBT.CB.61472697
WA

Other

Enumeration date
09/11/2023
Last updated
02/24/2025
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