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Contact Information

THEODUS J JORDAN, REVEREND
804 CENTRE STREET
300840 --MAILING
JAMAICA PLAIN, MA02130-0000
 Phone: 508-588-6443
 Fax: 508-588-6443
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Pastoral

101YP1600X
 

Professional

101YP2500X
Indicates primary specialty

NPI Profile & details for THEODUS J JORDAN · (Male)

NPI Number 1700226321
Status Active
Credentials REVEREND
Entity Individual
Enumeration date 06/27/2013
Last updated 06/27/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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