| Jordan Fonseca Llc | |
|
970 Logan St Ste 110 Noblesville IN 46060-2253 | |
| (317) 714-7974 | |
| Not Available |
| Full Name | Jordan Fonseca Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 970 Logan St Ste 110, Noblesville, Indiana |
| Authorized Official Name and Position | Jordan Fonseca (THERAPIST) |
| Authorized Official Contact | 3177147974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Fonseca Llc 695 Jefferson St Fortville IN 46040-1739 Ph: () - | Jordan Fonseca Llc 970 Logan St Ste 110 Noblesville IN 46060-2253 Ph: (317) 714-7974 |
| NPI Number | 1689369746 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689369746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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