Individual
DR. ROBERT HERBERT JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
510 E STONER AVE, OVERTON BROOKS VA MEDICAL CENTER--116B, SHREVEPORT, LA 71101-4243
(318) 424-6051
Mailing address
2047 CAPTAIN SHREVE DR, SHREVEPORT, LA 71105-3819
(318) 861-0167
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
546
LA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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