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118 N Ross St Suite 2 Auburn AL 36830-4869 | |
| (334) 332-5214 | |
| (334) 329-6063 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 118 N Ross St, Auburn, Alabama |
| Authorized Official Name and Position | Ashley Jordan (OWNER) |
| Authorized Official Contact | 3343296063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 871 Auburn AL 36831-0871 Ph: (334) 329-6063 | 118 N Ross St Suite 2 Auburn AL 36830-4869 Ph: (334) 332-5214 |
| NPI Number | 1073901013 |
|---|---|
| Provider Enumeration Date | 12/29/2014 |
| Last Update Date | 07/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073901013 | NPI | - | NPPES |
| 102I808963 | Other | AL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3680C (Alabama) | Primary |
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