Individual
JORDAN BRUBAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
14275 MIDWAY RD STE 260, ADDISON, TX 75001-3613
(405) 534-4522
Mailing address
14275 MIDWAY RD STE 260, ADDISON, TX 75001-3613
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/07/2022
Last updated
06/14/2022
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