Jordan David Mathisen, LCSW

NPI #1962783852 in Cabot, Arkansas

Provider Information

NPI Number: 1962783852
Entity Type: Individual
Name: Jordan David Mathisen, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LCSW
Enumeration Date: Sep 6, 2011
Last Updated: Nov 4, 2014

Practice Location

Address: 203B WESTPORT DR
City: Cabot
State: Arkansas
ZIP Code: 72023-3657
Phone: (501) 843-9233

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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