Individual
VAISHALI JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3255 LOUISE PL, MACON, GA 31204-1948
(478) 718-7280
Mailing address
3255 LOUISE PL, MACON, GA 31204-1948
(478) 718-7280
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001597
GA
Other
Enumeration date
12/02/2025
Last updated
12/02/2025
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