Individual
JUDITH JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9 N MAIN ST, #8, EAST HAMPTON, NY 11937-2632
(917) 825-4905
Mailing address
PO BOX 1696, AMAGANSETT, NY 11930-1696
(917) 825-4905
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
077715-1
NY
Other
Enumeration date
07/07/2015
Last updated
07/07/2015
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