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Individual

JORDAN KEILAH PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10107 CHERRY LN APT 304, NAMPA, ID 83687-1079
(205) 422-1969
Mailing address
10107 CHERRY LN APT 304, NAMPA, ID 83687-1079
(205) 422-1969

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-426805
ID
171M00000X
Case Manager/Care Coordinator
ID

Other

Enumeration date
04/30/2025
Last updated
06/26/2026
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