Jordan Southern

NPI #1558089300 in Chehalis, Washington

Provider Information

NPI Number: 1558089300
Entity Type: Individual
Name: Jordan Southern
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 18, 2022
Last Updated: Aug 18, 2022

Practice Location

Address: 135 W MAIN ST
City: Chehalis
State: Washington
ZIP Code: 98532-4817
Phone: (360) 748-4339

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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