Provider Demographics
NPI:1174269799
Name:MUNROE, JAMIE (RBT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MUNROE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25331
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00824-1331
Mailing Address - Country:US
Mailing Address - Phone:134-064-2739
Mailing Address - Fax:
Practice Address - Street 1:6079 ESTATE PETERS RST STE 1
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-5803
Practice Address - Country:US
Practice Address - Phone:340-642-7390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst