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Individual
JORDAN DEACON HUMPHREYS
Active
Individual
JORDAN DEACON HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.ED
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701012699
VA
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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