Most Relevant Information
Provider Data
| NPI Number: | 1003690223 |
| Provider Name: | JORDAN ROOT LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 68895 |
Most Important Dates
| Enumeration Date: | 08/21/2023 |
| Last Updated: | 08/21/2023 |
Provider Practice Location
11440 MCCREE RD APT 1231
DALLAS
TX
752383239
Practice Location Phone/Fax
| Phone: | 2147139575 |
| Fax: |
Provider Mailing Location
11440 MCCREE RD APT 1231
DALLAS
TX
752383239
Provider Mailing Phone/Fax
| Phone: | 2147139575 |
| Fax: |