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Individual
BRIANISHA MARIA JORDAN
Active
Individual
BRIANISHA MARIA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
133N00000X
Nutritionist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1404690171
—
NV
Enumeration date
09/16/2013
Last updated
10/04/2013
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