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Individual

JORDAN T BLADES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
4015 SW 21ST ST, TOPEKA, KS 66604-3412
(785) 266-0202
Mailing address
4015 SW 21ST ST, TOPEKA, KS 66604-3412
(785) 266-0202

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1642
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1669
KS

Other

Enumeration date
06/26/2019
Last updated
12/23/2019
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