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Individual
JACQUELINE D JORDAN
Active
Individual
JACQUELINE D JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10081
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E92967
VIVA
AL
Enumeration date
06/28/2006
Last updated
07/08/2007
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