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Individual
DIANE EVELYN JORDAN
Active
Individual
DIANE EVELYN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, NCC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3323
MT
101YM0800X
Mental Health Counselor
Primary
7932
MT
Other
Enumeration date
02/19/2014
Last updated
11/01/2016
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