Individual
PUELLA LEE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4653 E MAIN ST, COLUMBUS, OH 43213-3298
(614) 875-2371
Mailing address
4653 E MAIN ST, COLUMBUS, OH 43213-3298
(614) 875-2371
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
04/23/2018
Last updated
02/08/2023
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