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General NPI Number Information
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NPI Number | 1891640827
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Entity Type | Individual
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Provider Name | JORDAN KIDWELL
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Gender | Female
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 57 W WATERLOO ST STE 103
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-1180
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Country | US
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Telephone | 614-321-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 57 W WATERLOO ST STE 103
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-1180
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Country | US
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Telephone | 614-321-4010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2410777
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License Number State | OH
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