Tre Jordan
Behavior Analyst in Dearborn, MI. Individual provider (NPI-1).
NPI number1801380654
StatusActive
Last updated in NPPESJun 12, 2022
Details
- NPI
- 1801380654
- Entity type
- Individual (NPI-1)
- Name
- Tre Jordan
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 15, 2018
- Certification date
- Oct 19, 2021
- Last updated
- Jun 12, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
| 106S00000X | Behavior Technician | – | – | |
| 247200000X | Technician, Other | – | MI |
Practice location
19853 Outer Dr Ste 110Dearborn, MI 48124-2044
Phone 313-406-5056 · Fax 248-712-4381
Mailing address
19853 Outer Dr Ste 110Dearborn, MI 48124-2044
Phone 313-406-5056 · Fax 248-712-4381
Other practice locations
400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502
Detroit, MI 48243-1502
Phone 855-832-6727
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