Individual
GINA CHANETTE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36 CRAWFORD ST APT 2, BOSTON, MA 02121-2416
(857) 247-1432
Mailing address
36 CRAWFORD ST APT 2, BOSTON, MA 02121-2416
(857) 247-1432
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/19/2022
Last updated
05/19/2022
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