Provider Demographics
NPI:1881447209
Name:JORDYN REESER LLC
Entity type:Organization
Organization Name:JORDYN REESER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:JORDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:REESER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:503-317-2050
Mailing Address - Street 1:2387 S KIHEI RD APT B106
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7274
Mailing Address - Country:US
Mailing Address - Phone:503-317-2050
Mailing Address - Fax:
Practice Address - Street 1:2387 S KIHEI RD APT B106
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7274
Practice Address - Country:US
Practice Address - Phone:503-317-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty