Individual
KETRINA LYNN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD
Contact information
Practice address
204 ALABAMA AVE SW, FORT PAYNE, AL 35967-1953
(256) 979-1777
Mailing address
204 ALABAMA AVE SW, FORT PAYNE, AL 35967-1953
(256) 979-1777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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