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1205399326
BETH ELLEN JORDAN
MATTOON, IL
NPI
1205399326
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Former Name
BETH ELLEN PENDERGAST
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-04-08
Last Update Date
2019-04-08
Business Address
BETH ELLEN JORDAN RSA
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5700
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Mailing Address
BETH ELLEN JORDAN RSA
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number:
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