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Individual

JORDAN JEFFREY JOLLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
634 EDDY AVE, MISSOULA, MT 59812-1802
(406) 243-4712
Mailing address
270 BROKEN TOP LN APT 212, MISSOULA, MT 59802-3252
(815) 419-7204

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
51413
MT

Other

Enumeration date
01/11/2022
Last updated
01/11/2022
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