Individual
MRS. KATHRYN V JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
3122 VASHTI RD, TAYLORSVILLE, NC 28681-6828
(336) 644-3510
Mailing address
763 SHADY HANES RD, LEXINGTON, NC 27295-8604
(336) 644-3510
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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