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1376294488
JORDAN JEFFREY JOLLY
MISSOULA, MT
NPI
1376294488
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MT 51413)
Enumeration Date
2022-01-11
Last Update Date
2022-01-11
Business Address
JORDAN JEFFREY JOLLY LCPC
634 EDDY AVE
MISSOULA, MT 59812-1802
Phone number: 406-243-4712
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Mailing Address
JORDAN JEFFREY JOLLY LCPC
270 BROKEN TOP LN APT 212
MISSOULA, MT 59802-3252
Phone number: 815-419-7204
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