Johnny Lee Jordan
Peer Specialist in Saint Joseph, MI. Individual provider (NPI-1).
NPI number1891359634
StatusActive
Last updated in NPPESApr 26, 2019
Details
- NPI
- 1891359634
- Entity type
- Individual (NPI-1)
- Name
- Johnny Lee Jordan
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2019
- Last updated
- Apr 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
4032 M 139 Ste 108Saint Joseph, MI 49085-8664
Phone 269-556-1526
Mailing address
4032 M 139 Ste 108Saint Joseph, MI 49085-8664
Phone 269-556-1526
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All 17 Peer Specialist providers in Saint Joseph · All 1,334 providers in Saint Joseph
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