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Individual

JORDAN GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 MERCY DR, ORLANDO, FL 32808-5646
(407) 875-3700
Mailing address
5151 ADANSON ST, ORLANDO, FL 32804-1317

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
BACB754901
FL
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
03/14/2022
Last updated
04/02/2024
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