MEDICARE: JORDAN M ROOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PS018463	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720494891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN M ROOD

Provider Business Mailing Address
First Line	:	196 W ASHLAND ST # 520
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	814-404-9208
Fax Number	:

Provider Business Practice Location Address
First Line	:	196 W ASHLAND ST # 520
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-4040
Country	:	US
Telephone Number	:	814-404-9208
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	06/03/2024

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Directions to “ JORDAN M ROOD ” Practice Location

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