Individual
JORDAN MARIE CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
187 W BROAD ST, SPARTANBURG, SC 29306-3234
(864) 582-7588
Mailing address
160 TUSCANY LN, CHESNEE, SC 29323-8119
(864) 384-4828
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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