Provider Demographics
NPI:1407970668
Name:JORDAN, NAMIR E (MS)
Entity Type:Individual
Prefix:PROF
First Name:NAMIR
Middle Name:E
Last Name:JORDAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PASEO OQUIDEAS #64 PRIMAVERA
Mailing Address - Street 2:ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-751-6518
Practice Address - Street 1:PASEO OQUIDEAS #64 PRIMAVERA
Practice Address - Street 2:ENCANTADA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-751-6518
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1273103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist