Dormer, Jordan A

Dormer, Jordan A is an individual health care provider with primary practice located at 145 E Edgewood Dr , Lakeland FL 33803-4014. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Dormer, Jordan A can be contacted via phone (941) 380-0301.

Contact Information

Primary practice address
145 E Edgewood Dr Lakeland FL 33803-4014
Phone: (941) 380-0301
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1952773483
LBN Legal business name Dormer, Jordan A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2015
Last updated May 31st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952773483 NPPES
Florida MEDICAID 113333400

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