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General NPI Number Information
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NPI Number | 1346518503
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Entity Type | Organization
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Legal Business Name | JANET GILCHRIST JORDAN PHD PLLC
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 628 E PARENT AVE STE 109
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City | ROYAL OAK
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State | MI
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Zip | 48067-3766
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Country | US
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Telephone | 248-563-2290
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Fax | 248-543-4440
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Provider Business Mailing Address
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Address Line | 628 E PARENT AVE STE 109
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City | ROYAL OAK
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State | MI
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Zip | 48067-3766
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Country | US
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Telephone | 248-563-2290
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Fax | 248-543-4440
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JANET GILCHRIST JORDAN
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Credential | PHD
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Telephone | 248-563-2290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301011483
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License Number State | MI
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