Doctor Name: | MRS. MARY ELIZABETH JORDAN |
NPI Number: | 1063712040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW, IADC |
License Number: | 007068 |
Business Practice Address: | 1551 Indian Hills Dr Ste 206 Sioux City, IA - 511041857 |
Business Phone Number: | 7122584700 |
Business Fax Number: | |
Mailing Address: | 1551 Indian Hills Dr Ste 206, SIOUX CITY |
State: | IA |
Postal Code: | 511041857 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/25/2010 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 007068 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |