Individual
ELIZABETH JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMSC, CGC
Contact information
Practice address
452 W 10TH AVE, COLUMBUS, OH 43210-1240
(614) 293-7677
Mailing address
460 W 12TH AVE RM 339, COLUMBUS, OH 43210-2210
(614) 366-3597
(614) 688-1381
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
00000
KY
170300000X
Genetic Counselor (M.S.)
Primary
70.000283
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CS1719300252
—
OH
Enumeration date
04/12/2017
Last updated
10/10/2017
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