Provider Demographics
NPI:1477699536
Name:EDWARDS, JORIE H (PHD)
Entity Type:Individual
Prefix:DR
First Name:JORIE
Middle Name:H
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JORIE
Other - Middle Name:L
Other - Last Name:HITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3408 WOODLAND AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6506
Mailing Address - Country:US
Mailing Address - Phone:515-225-2015
Mailing Address - Fax:515-225-1744
Practice Address - Street 1:3408 WOODLAND AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6506
Practice Address - Country:US
Practice Address - Phone:515-225-2015
Practice Address - Fax:515-225-1744
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01012103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist