Individual
MS. JORDAN ELISE TADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMFT
Contact information
Practice address
212 E TREMONT AVE, SUITE C, CHARLOTTE, NC 28203-5366
(704) 229-9100
Mailing address
212 E TREMONT AVE, SUITE C, CHARLOTTE, NC 28203-5366
(704) 229-9100
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFTA10050A
NC
Other
Enumeration date
02/26/2015
Last updated
02/26/2015
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