Provider Demographics
NPI:1093232365
Name:CROWLEY, JAIME DORIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:DORIAN
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 LAKEMONT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-1708
Mailing Address - Country:US
Mailing Address - Phone:972-914-9212
Mailing Address - Fax:
Practice Address - Street 1:5949 SHERRY LN STE 1235
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-8067
Practice Address - Country:US
Practice Address - Phone:972-914-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2017-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36469103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical