Most Relevant Information
Provider Data
| NPI Number: | 1003229246 |
| Provider Name: | JORDAN NATHANIEL SMITH LLMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | 4101006611 |
Most Important Dates
| Enumeration Date: | 06/05/2014 |
| Last Updated: | 06/05/2014 |
Provider Practice Location
1101 BALL AVE NE
GRAND RAPIDS
MI
49505
Practice Location Phone/Fax
| Phone: | 6164566571 |
| Fax: | 6164585430 |
Provider Mailing Location
1101 BALL AVE NE
GRAND RAPIDS
MI
495055904
Provider Mailing Phone/Fax
| Phone: | 6164566571 |
| Fax: | 6164585430 |