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1588372478
MARK LAMARR JORDAN
SAN DIEGO, CA
NPI
1588372478
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 13508)
Enumeration Date
2022-11-09
Last Update Date
2022-11-09
Business Address
MARK LAMARR JORDAN
1733 EUCLID AVE
SAN DIEGO, CA 92105-5414
Phone number: 619-263-0433
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Mailing Address
MARK LAMARR JORDAN
6634 GARBER AVE
SAN DIEGO, CA 92139-3815
Phone number: 619-852-4734
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