| Tyshonna Domrae Jordan, | |
|
12318 Boydton Plank Rd., Dinwiddie, VA 23841 | |
| (804) 504-9089 | |
| Not Available |
| Full Name | Tyshonna Domrae Jordan |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 12318 Boydton Plank Rd., Dinwiddie, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225546153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Tyshonna Domrae Jordan, 5310 Moody Dr, North Dinwiddie, VA 23803-8706 Ph: () - | Tyshonna Domrae Jordan, 12318 Boydton Plank Rd., Dinwiddie, VA 23841 Ph: (804) 504-9089 |
Candace Dionelle Black-roney, LPC, SOTP, SATP CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19234 Turkey Egg Rd, Dinwiddie, VA 23841 Phone: 804-586-2503 Fax: 804-469-9570 | |
Zuri Blizzard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12318 Boydton Plank Rd, Dinwiddie, VA 23841 Phone: 804-591-5836 | |
Mrs. Jamonica Renee Worsham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12318 Boydton Plank Rd, Dinwiddie, VA 23841 Phone: 804-469-5313 |