Individual
ANGELICA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4570 REESE RD # B, COLUMBUS, GA 31907-1177
(706) 780-6497
Mailing address
20 PEPPERTREE CT, COLUMBUS, GA 31909-2642
(706) 584-1268
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC012068
GA
Other
Enumeration date
03/02/2017
Last updated
12/23/2021
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