| NPI | 1831329945 |
|---|---|
| Former Name | LISA J JORDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3720) |
| Additional Taxonomies | 104100000X Social Worker (Licence: 5547) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2020-04-23 |