Individual
ANGELIA DENISE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6763 PAGE AVE, SAINT LOUIS, MO 63133-1635
(314) 320-6728
Mailing address
1430 OLIVE ST, SAINT LOUIS, MO 63103-2360
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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