Individual
AMANDA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 ESTON DR, GOOSE CREEK, SC 29445-7131
(803) 899-5283
Mailing address
112 ESTON DR, GOOSE CREEK, SC 29445-7131
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
366
SC
101YP2500X
Professional Counselor
Primary
6951
SC
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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