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Individual

CHARLOTTE F. JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4611 WESTERN BOULEVARD, RALEIGH, NC 27606
(919) 219-8534
Mailing address
1409 CRETE DRIVE, RALEIGH, NC 27606
(919) 219-8534
(919) 219-8534

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C001784
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6003118
NC
Enumeration date
10/03/2006
Last updated
07/08/2007
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