# PHOEBE JORDAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1770141194
- **Gender:** F
- **Credential:** PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 6301019280 | MI | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | P.08192 | OH | — |

## Other

- **Enumeration date:** 05/31/2019
- **Last updated:** 10/18/2023