Jordan Dilts
Individual provider Active NPI School Psychologist · Odessa, DE
NPI 1104596758 · NPPES record last updated Sep 15, 2021
Key facts
- NPI
- 1104596758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 109463 (DE)
- Practice address
- 313 S 5TH St
Odessa, DE 19730-2078 - Phone
- (302) 376-4128
- NPI assigned
- Sep 15, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109463 | DE | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Delaware | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 109463 | DE | Yes |
Addresses
Primary practice location
313 S 5TH St
Odessa, DE 19730-2078
Mailing address
528 Turnberry CT
Bear, DE 19701-4729
Other providers in Odessa, DE
- Caitlin Davis
- Christine Davis
- Lindsey Davis
- Alexis Deionno
- Denise C. Wall, LCSW LLC
- Elizabeth Denise Dowell
- Ashley Doyle
- Phillip G. Ealy
- Cassidy Edmondson
- Cheri Ruff Eleazar
All providers in Odessa, DE · School Psychologist in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.