Organization
JORDANICA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. PREMSELAAR LCSW (PRESIDENT)
(702) 358-0464
Entity
Organization
Contact information
Practice address
780 CORONADO CENTER DR, SUITE 110A, HENDERSON, NV 89052-5040
(702) 358-0464
(610) 432-3508
Mailing address
780 CORONADO CENTER DR, SUITE 110A, HENDERSON, NV 89052-5040
(702) 358-0464
(610) 432-3508
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5782C
NV
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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