Individual
JORDAN LETHOMMIUS PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
318 W LOUISIANA AVE LOT 8, RUSTON, LA 71270-9304
(318) 840-9287
Mailing address
318 W LOUISIANA AVE LOT 8, RUSTON, LA 71270-9304
(318) 840-9287
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PLC8804
LA
171M00000X
Case Manager/Care Coordinator
—
LA
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/12/2022
Last updated
09/13/2023
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