Individual
KAIMILE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(951) 200-0553
Mailing address
5872 OLD JACKSONVILLE HWY APT 137, TYLER, TX 75703-0598
(951) 200-0553
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/10/2021
Last updated
06/23/2021
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