Provider Demographics
NPI:1104179027
Name:SEYFFERT, JAIME
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:SEYFFERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 BARRANCA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4601
Mailing Address - Country:US
Mailing Address - Phone:915-779-5600
Mailing Address - Fax:915-779-5605
Practice Address - Street 1:320 MCCOMBS RD
Practice Address - Street 2:SPC C
Practice Address - City:CHAPARRAL
Practice Address - State:NM
Practice Address - Zip Code:88081-7937
Practice Address - Country:US
Practice Address - Phone:575-824-5340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0153451101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health