Individual
LAKING JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1281 MOSSER DR, COLUMBIA, SC 29203-9225
(803) 529-5615
Mailing address
1281 MOSSER DR, COLUMBIA, SC 29203-9225
(803) 529-5615
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
SC
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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