Individual
MRS. CLEVEVOYA DALETREASE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
127 ENTERPRISE PATH STE 401, HIRAM, GA 30141-2698
(770) 222-6622
(404) 284-1804
Mailing address
2506 GREENVILLE WAY, DECATUR, GA 30034-1861
(678) 887-6613
(404) 284-1804
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0003921
GA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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