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Individual

MRS. JORDAN NICOLE CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA

Contact information

Practice address
21300 CATAWBA AVE, CORNELIUS, NC 28031-8505
(405) 473-7178
(704) 943-0512
Mailing address
16430 LEAVITT LN, DAVIDSON, NC 28036-8947
(405) 473-7178
(704) 943-0512

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
11/01/2012
Last updated
10/17/2019
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