Individual
JOURDAN MCKENZIE DIQUARTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBA
Contact information
Practice address
1101 W MOANA LN, SUITE 2, RENO, NV 89509-4775
(775) 337-2394
Mailing address
1101 W MOANA LN, SUITE 2, RENO, NV 89509-4775
(775) 337-2394
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005052160
—
NV
Enumeration date
03/07/2011
Last updated
11/06/2014
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