Individual
JORDAN MARIE FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
970 LOGAN ST STE 110, NOBLESVILLE, IN 46060-2253
(317) 760-1446
Mailing address
8474 SUMMERTREE LN, INDIANAPOLIS, IN 46256-3484
(317) 714-7974
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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