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Individual
MRS. ROSALIE ADAM JORDAN
Active
Individual
MRS. ROSALIE ADAM JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA RN LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0106
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18593
PHP
NM
01
—
NM100011
VALUE OP
NM
Enumeration date
06/27/2006
Last updated
06/07/2016
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