Individual
DIANE MAXINE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
2704 OAKCREST PL, CHARLOTTE, NC 28209-1127
(704) 309-5107
Mailing address
2704 OAKCREST PL, CHARLOTTE, NC 28209-1127
(704) 309-5107
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A12587
NC
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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