Jordan Holbrook
Counselor, Professional in Saint Louis, MO. Individual provider (NPI-1).
NPI number1194352500
StatusActive
Last updated in NPPESMar 25, 2020
Details
- NPI
- 1194352500
- Entity type
- Individual (NPI-1)
- Name
- Jordan Holbrook
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 25, 2020
- Certification date
- Mar 25, 2020
- Last updated
- Mar 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 2018045606 | MO | Yes |
Practice location
222 S Meramec Ave Ste 303Saint Louis, MO 63105-3514
Phone 423-298-8653
Mailing address
15041 Baxter Village Dr Apt DChesterfield, MO 63017-7873
Phone 423-298-8653
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