| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AMY JORDAN | 1679224133 | 2022-01-15 |
Amy Jordan is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1679224133. Registration indicates Amy Jordan is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Psychologist (Behavioral Health & Social Service Providers, Psychologist) (Psychologist: School, ) (Psychologist School, Behavioral Health & Social Service Providers) (Psychologist, )
| Entity Type | Individual |
| Provider Name | Amy Jordan |
| Practice Office Address | N2767 SHADY ACRE DR NEW LONDON, WI US |
| Practice Office Telephone | 9209820147 |
| Mailing Address | N2767 SHADY ACRE DR NEW LONDON, WI 549619136 US |
| Business Telephone | 9209820147 |
| Code | Practice | License No State |
|---|---|---|
| 103TS0200X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Psychologist Behavioral Health & Social Service Providers Psychologist Psychologist: School Psychologist School Behavioral Health & Social Service Providers Psychologist |