Individual
RENEE S JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASTERS IN EDUCATION
Contact information
Practice address
2110 OAK PARK BLVD, LAKE CHARLES, LA 70601-7864
(337) 475-0324
(337) 475-8917
Mailing address
5415 MATTIE REEVES RD, LAKE CHARLES, LA 70611-5719
(337) 540-7098
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
246ZA2600X
Medical Art Specialist/Technologist
—
—
Other
Enumeration date
11/27/2018
Last updated
08/22/2024
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