Individual
MAHALA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2808 FOX CHASE LN, MIDLOTHIAN, VA 23112-4008
(508) 561-1070
Mailing address
46 BEACON ST, PORTLAND, ME 04103-4014
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701009781
VA
101YM0800X
Mental Health Counselor
CC6968
ME
Other
Enumeration date
08/28/2020
Last updated
04/16/2025
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