Individual
MARISSA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
268 CHRISTIAN CHURCH RD STE 2, JOHNSON CITY, TN 37615-4484
(423) 491-4202
(423) 388-4774
Mailing address
27 6TH ST, BRISTOL, TN 37620-2212
(423) 573-6836
(423) 388-4774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C.1500150
OH
101YP2500X
Professional Counselor
Primary
4767
TN
Other
Enumeration date
02/23/2016
Last updated
01/07/2020
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