Individual
DR. TERRENCE A JORDAN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
4946 CREEKSIDE LN, POWDER SPRINGS, GA 30127-3295
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810006893
VA
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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