Organization
J M JORDAN PSYCHOLOGY PROFESSIONAL CORPORATION
Active
Other names
Eagle Therapist Collective
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JORDAN PSYD (DIRECTOR)
(925) 724-3427
Entity
Organization
Contact information
Practice address
1065 E WINDING CREEK DR STE 250, EAGLE, ID 83616-7246
(208) 805-2324
Mailing address
1065 E WINDING CREEK DR STE 250, EAGLE, ID 83616-7246
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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