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1508602087
GEANCARLO ISRAEL JORDAN
NEW YORK, NY
NPI
1508602087
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NY 18-P118246-01)
Enumeration Date
2024-07-03
Last Update Date
2024-07-03
Business Address
GEANCARLO ISRAEL JORDAN MHC-LP
303 5TH AVE RM 1503
NEW YORK, NY 10016-6666
Phone number: 646-359-4345
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Mailing Address
GEANCARLO ISRAEL JORDAN MHC-LP
1416 WYTHE PL APT 1A
BRONX, NY 10452-6921
Phone number: 646-359-4345
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