Individual
DR. TIMI DEE FRIEDERICHS JORDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD; EDS
Contact information
Practice address
1728 CENTRAL AVE, STE. 14, FORT DODGE, IA 50501-4200
(515) 573-3628
(515) 573-3682
Mailing address
1728 CENTRAL AVE, STE. 14, FORT DODGE, IA 50501-4200
(515) 573-3628
(515) 573-3682
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
322774
IA
103TC0700X
Clinical Psychologist
Primary
001080
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159608
—
IA
01
—
07466
WELLMARK BC/BS
IA
Enumeration date
10/16/2006
Last updated
08/09/2010
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