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Individual
JORDAN THORNLEY
Active
Individual
JORDAN THORNLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP-T
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG60506919
WA
390200000X
Student in an Organized Health Care Education/Training Program
CO60451299
WA
Other
Enumeration date
08/18/2014
Last updated
10/10/2014
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