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Individual

BRIANISHA MARIA JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5185 CAMINO AL NORTE, SUITE 120, N LAS VEGAS, NV 89031-2415
(702) 600-9433
Mailing address
5185 CAMINO AL NORTE, SUITE 120, N LAS VEGAS, NV 89031-2415
(702) 600-9433

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103K00000X
Behavior Analyst
Primary
133N00000X
Nutritionist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1404690171
NV
Enumeration date
09/16/2013
Last updated
10/04/2013
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