Individual
MS. TONI RENEE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.T.
Contact information
Practice address
472 S LINCOLN AVE, KANKAKEE, IL 60901-5530
(815) 953-8939
Mailing address
472 S LINCOLN AVE, KANKAKEE, IL 60901-5530
(815) 953-8939
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/08/2010
Last updated
07/08/2010
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