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General NPI Number Information
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NPI Number | 1306562715
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Entity Type | Individual
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Provider Name | ATURA JORDAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/17/2022
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 27 S MAIN ST
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City | JASPER
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State | GA
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Zip | 30143-1600
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Country | US
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Telephone | 706-455-7067
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Fax | 770-585-0001
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Provider Business Mailing Address
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Address Line | 60 HILLTOP LN APT 4B
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City | BLUE RIDGE
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State | GA
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Zip | 30513-7203
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Country | US
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Telephone | 706-455-7067
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Fax | 678-944-8197
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 008197
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License Number State | GA
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