Individual
AMBER DAWN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
Mailing address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2022004181
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022004181
LICENSED CLINICAL SOCIAL WORKER
MO
Enumeration date
01/16/2025
Last updated
01/16/2025
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