Individual
BROOKE J JORDAN
Active
Individual
BROOKE J JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
36330
CA
Other
Enumeration date
03/28/2013
Last updated
03/28/2013
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