Individual
JORDANA GABRIELLE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12401 ORANGE DR STE 224, DAVIE, FL 33330-4343
(954) 385-4696
Mailing address
12401 ORANGE DR STE 224, DAVIE, FL 33330-4343
(954) 385-4696
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY12872
FL
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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