Individual
DEEDRA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 NW 160TH ST, EDMOND, OK 73013-2038
(405) 735-9732
Mailing address
200 NW 160TH ST, EDMOND, OK 73013-2038
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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