Individual
JORDAN PARIS LEUTHOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPCC
Contact information
Practice address
21395 JOHN MILLESS DR STE 400, ROGERS, MN 55374-4407
(763) 424-1888
Mailing address
13477 73RD PL N, MAPLE GROVE, MN 55311-2831
(952) 484-6892
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC02131
MN
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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