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Individual

MRS. JEANETTE MIDDLE JORDAN-HUFFAM OFFICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
3911 W BENT GRASS DR, FAYETTEVILLE, NC 28312-8791
(910) 308-1641
Mailing address
3911 W BENT GRASS DR, FAYETTEVILLE, NC 28312-8791
(910) 308-1641

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
148
NC
101YM0800X
Mental Health Counselor
Primary
821
NC

Other

Enumeration date
07/29/2020
Last updated
07/29/2020
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