Individual
DONNA ELAINE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
882 WITHERBY LN, LEWISVILLE, TX 75067-4474
(469) 389-0715
Mailing address
882 WITHERBY LN, LEWISVILLE, TX 75067-4474
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
71255
TX
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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