Individual
JORDANE HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 BREVARD CT STE B, ALEXANDRIA, LA 71303-3997
(318) 238-4030
Mailing address
1403 HICKORY CT, ALEXANDRIA, LA 71303-5505
(318) 541-5367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
02/10/2017
Last updated
07/31/2020
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