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Individual

JORDAN LOUIS KITCHENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
297 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23462-2911
(757) 385-4789
Mailing address
297 INDEPENDENCE BLVD, VIRGINIA BEACH, VA 23462-2911
(757) 385-4789

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904016856
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
12/01/2020
Last updated
06/04/2024
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