Individual
JORDAN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
524 CENTRAL AVE SW, ALBUQUERQUE, NM 87102-3124
(505) 243-3308
Mailing address
524 CENTRAL AVE SW, ALBUQUERQUE, NM 87102-3124
(505) 243-3308
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
SWB-2022-0751
NM
Other
Enumeration date
03/30/2023
Last updated
03/30/2023
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