Individual
DR. JORDANA ELYSE MORTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1208 W MAGNOLIA AVE STE 234, FORT WORTH, TX 76104-8801
(817) 989-6312
Mailing address
6909 CHURCH PARK DR, FORT WORTH, TX 76133-6856
(817) 845-1562
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
36926
TX
103TS0200X
School Psychologist
70174
TX
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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