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General NPI Number Information
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NPI Number | 1023449279
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Entity Type | Organization
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Legal Business Name | JORDAN THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 1100 NASA PKWY SUITE 110
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City | HOUSTON
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State | TX
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Zip | 77058-3325
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Country | US
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Telephone | 281-317-7237
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Fax |
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Provider Business Mailing Address
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Address Line | 125 RUSTIC COLONY LN
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City | DICKINSON
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State | TX
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Zip | 77539-4899
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Country | US
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Telephone | 281-317-7237
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | LAURA JANE JORDAN
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Credential | LPC, LMFT
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Telephone | 281-317-7237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 66853
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 201649
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License Number State | TX
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