Individual
SHANE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8230 LEESBURG PIKE STE 740, VIENNA, VA 22182-2641
(877) 504-4141
Mailing address
1325 S STATE ST, DOVER, DE 19901-4945
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66606
—
Other
Enumeration date
03/14/2019
Last updated
10/12/2024
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