Individual provider · Type 1 NPI
Jordin Leigh Bourque, LMSW
Mental Health Counselor · Phoenix, AZ
NPI number
1861155780
Active
Practice location
3943 W Griswold Rd
Phoenix, AZ 85051-4633
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Mental Health Counselor Primary | 101YM0800X | LMSW-18617 (AZ) |
Mental Health Counselor: Definition to come...
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About NPI 1861155780
Jordin Leigh Bourque, LMSW's National Provider Identifier is 1861155780, issued on Oct 18, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 18, 2021.