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NPI Code Detail

MEDICARE: LILLIANE JORDAN

MEDICARE: LILLIANE JORDAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1245183219
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILLIANE JORDAN
Provider Business Mailing Address
First Line : 445 E DUBLIN GRANVILLE RD
Second Line :
City : WORTHINGTON
State : OH
Zip : 43085-3192
Country : US
Telephone Number : 614-844-3800
Fax Number :
Provider Business Practice Location Address
First Line : 445 E DUBLIN GRANVILLE RD
Second Line :
City : WORTHINGTON
State : OH
Zip : 43085-3192
Country : US
Telephone Number : 614-844-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2026
Last Update Date : 02/18/2026

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Directions to “ LILLIANE JORDAN ” Practice Location

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