Individual
SAMANTHA R JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2520 WINDY HILL RD SE, SUITE 203, MARIETTA, GA 30067-8664
(770) 953-6401
(770) 953-6015
Mailing address
2520 WINDY HILL RD SE, SUITE 203, MARIETTA, GA 30067-8664
(770) 953-6401
(770) 953-6015
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003632
GA
Other
Enumeration date
11/12/2012
Last updated
11/12/2012
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