Individual
JORDAN NICOLE BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2807 AMBERWOOD CT, COLUMBIA, MO 65203-4734
(217) 415-3406
Mailing address
2807 AMBERWOOD CT, COLUMBIA, MO 65203-4734
(217) 415-3406
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149018700
IL
1041C0700X
Clinical Social Worker
Primary
2021008924
MO
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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