Individual
MS. JACKIE D JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
3700 N CLASSEN BLVD, SUITE C-55, OKLAHOMA CITY, OK 73118-2872
(405) 605-0881
(405) 605-0879
Mailing address
3700 N CLASSEN BLVD, SUITE C-55, OKLAHOMA CITY, OK 73118-2872
(405) 605-0881
(405) 605-0879
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
490
OK
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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