Individual
JORDAN TAYLOR NICKEL-DUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
811 NW 19TH AVE # 301, PORTLAND, OR 97209-1401
(503) 866-0299
Mailing address
1725 SW SALMON ST APT 409, PORTLAND, OR 97205-3845
(818) 635-3808
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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