Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-29854 | IN |
NPI | 1003311440 |
---|---|
Provider Name | Mrs. Jordan Lynn Silk |
First Address | Fishers, IN 46038-9183 |
Second Address | Indianapolis, IN 46250-3593 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2018 |
Last Update Date | 28/03/2018 |