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Individual

DR. KRISTA DIANE JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
4534 W GATE BLVD, SUITE 112, AUSTIN, TX 78745-1485
(512) 439-7360
(512) 439-7371
Mailing address
4534 W GATE BLVD, SUITE 112, AUSTIN, TX 78745-1485
(512) 439-7360
(512) 439-7371

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
26883
TX

Other

Enumeration date
10/13/2006
Last updated
04/20/2009
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