Individual
MS. JORDAN AMI DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
413 CENTRAL AVE APT D, DOLORES, CO 81323-8310
(719) 994-2808
Mailing address
PO BOX 1105, DOLORES, CO 81323-1105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001934
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09928551
CO
Other
Enumeration date
06/05/2017
Last updated
01/09/2025
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