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Individual

JORDAN BRAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LGPC

Contact information

Practice address
711 W 40TH ST, BALTIMORE, MD 21211-2120
(667) 309-3063
Mailing address
337 HOMELAND SOUTHWAY, BALTIMORE, MD 21212-4168

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP8847
MD

Other

Enumeration date
02/13/2019
Last updated
02/13/2019
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