| NPI | 1225296767 |
|---|---|
| Former Name | JORDAN ELIZABETH WALDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2008013472) |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2008-05-31 |