Individual
JORDAN TARA MARIE MEGLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, IIS, DSP, RBT
Contact information
Practice address
1337 S FOUNTAIN DR, OLATHE, KS 66061-7205
(913) 940-0597
Mailing address
1337 S FOUNTAIN DR, OLATHE, KS 66061-7205
(913) 940-0597
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB478372
KS
405300000X
Prevention Professional
NEFE92EA
CA
Other
Enumeration date
08/25/2020
Last updated
09/04/2020
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