Provider Demographics
NPI:1790980860
Name:JORDAN, HEATHER CHRISTENE (BS)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:CHRISTENE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SE 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-6779
Mailing Address - Country:US
Mailing Address - Phone:405-558-1816
Mailing Address - Fax:
Practice Address - Street 1:2100 SE 7TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-6779
Practice Address - Country:US
Practice Address - Phone:405-558-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor