Individual
JEFFERSON JORDAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8325 KELWOOD AVE, BATON ROUGE, LA 70806-4804
(225) 239-5498
Mailing address
8325 KELWOOD AVE, BATON ROUGE, LA 70806-4804
(225) 239-5498
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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