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General NPI Number Information
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NPI Number | 1447446083
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Entity Type | Individual
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Provider Name | RONDA RANEE JORDAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 6425 NW 27TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32653-7102
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Country | US
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Telephone | 239-287-1044
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Fax | 352-268-1090
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Provider Business Mailing Address
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Address Line | 6425 NW 27TH TER
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City | GAINESVILLE
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State | FL
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Zip | 32653-7102
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Country | US
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Telephone | 239-287-1044
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Fax | 352-268-1090
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7560
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7560
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License Number State | FL
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