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Individual

JORDAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5420 W SAHARA AVE STE 101, LAS VEGAS, NV 89146-0389
(702) 882-7827
Mailing address
6297 PEACH ORCHARD RD, LAS VEGAS, NV 89142-0990
(209) 207-1850

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225400000X
NV
Enumeration date
10/28/2016
Last updated
02/15/2017
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