Individual
JORDIN LEIGH BOURQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3943 W GRISWOLD RD, PHOENIX, AZ 85051-4633
(928) 925-5251
Mailing address
3943 W GRISWOLD RD, PHOENIX, AZ 85051-4633
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-18617
AZ
101YM0800X
Mental Health Counselor
—
AZ
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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