Individual
DEBBIE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1910 N LAKES PL, MERIDIAN, ID 83646
(208) 342-2273
(208) 323-9070
Mailing address
PO BOX 44582, BOISE, ID 83711-0582
(208) 342-2273
(208) 323-9070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC390
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010032560
REGENCE BLUE SHIELD OF ID
ID
01
—
Q4897
BLUE CROSS OF ID
ID
Enumeration date
01/05/2007
Last updated
07/08/2007
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