Individual
DERRICK LAMONT JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 MCBEE ST, LINCOLNTON, NC 28092
(704) 986-1500
Mailing address
350 PEE DEE AVE STE 101, ALBEMARLE, NC 28001-4945
(704) 986-1500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C008484
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/03/2010
Last updated
06/05/2019
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