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General NPI Number Information
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NPI Number | 1124729744
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Entity Type | Individual
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Provider Name | JORDAN LEIGH MAY MA
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Gender | Female
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Dates
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Enumeration Date | 03/10/2023
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 3435 ACTON HWY
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City | GRANBURY
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State | TX
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Zip | 76049-7505
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Country | US
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Telephone | 817-578-6775
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 POST OAK CT
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City | BEDFORD
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State | TX
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Zip | 76021-3432
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Country | US
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Telephone | 817-832-4319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 19-565
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 83642
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License Number State | TX
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