Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TE1100X | Exercise & Sports Psychologist | ||
N | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor | ||
N | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1972098366 |
---|---|
Provider Name | Jordan Janelle-Yvonne Jones |
First Address | Las Vegas, NV 89110-1703 |
Second Address | Las Vegas, NV 89119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2018 |
Last Update Date | 28/06/2018 |