Provider Demographics
NPI:1114705712
Name:MARTIN, JAMIE DANIELLE
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:DANIELLE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 HOPEWELL RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1265
Mailing Address - Country:US
Mailing Address - Phone:484-523-9634
Mailing Address - Fax:
Practice Address - Street 1:700 S HIGH ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19383-0001
Practice Address - Country:US
Practice Address - Phone:610-436-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor