| Doctor Name: | LINDA CAROL JORDAN |
| NPI Number: | 1184012452 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 316 W Main St Henryetta, OK - 744374240 |
| Business Phone Number: | 9186509292 |
| Business Fax Number: | 9186509720 |
| Mailing Address: | Po Box 109, OKEMAH |
| State: | OK |
| Postal Code: | 748590109 |
| Phone Number: | 9186503051 |
| Fax Number: | 9186509720 |
| NPI Enumeration Date: | 01/08/2015 |
| NPI Last Update Date: | 01/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |