Individual
STEPHANIE ROXANNE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
10280 MAPLE CV, VANCLEAVE, MS 39565-6596
(228) 238-2394
Mailing address
10280 MAPLE CV, VANCLEAVE, MS 39565-6596
(228) 238-2394
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
189317
MS
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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