JORDAN MICHAEL PETERSON STEPHAN

FORT WAYNE, IN
NPI1700642774
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  33011238A)
Enumeration Date2024-02-26
Last Update Date2024-02-26
Business Address
JORDAN MICHAEL PETERSON STEPHAN LSW
10016 MONTICELLO BLVD
FORT WAYNE, IN 46825-2193
Phone number: 920-379-5728
Mailing Address
JORDAN MICHAEL PETERSON STEPHAN LSW
10016 MONTICELLO BLVD
FORT WAYNE, IN 46825-2193
Phone number: 920-379-5728
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