Individual
JORDAN LEIGH WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1004 DRESSER CT STE 103, RALEIGH, NC 27609-7325
(919) 876-5658
Mailing address
104 DARTMOUTH RD APT 613, RALEIGH, NC 27609-8420
(828) 719-9100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5232
NC
Other
Enumeration date
07/14/2018
Last updated
07/14/2018
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