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1801595574
KEVIN MICHAEL JORDAN
TYLER, TX
NPI
1801595574
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 13944)
Enumeration Date
2023-03-01
Last Update Date
2023-03-01
Business Address
KEVIN MICHAEL JORDAN LCDC
1827 W GENTRY PKWY
TYLER, TX 75702-3929
Phone number: 903-630-7461
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Mailing Address
KEVIN MICHAEL JORDAN LCDC
715 ESTES DR
LONGVIEW, TX 75602-6102
Phone number: 903-900-2134
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