Individual
JEREMIAH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8094 SPOTSWOOD TRL, STANARDSVILLE, VA 22973-2846
(434) 939-9001
Mailing address
8094 SPOTSWOOD TRL, STANARDSVILLE, VA 22973-2846
(434) 939-9001
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0813000755
—
VA
Enumeration date
10/18/2018
Last updated
10/18/2018
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