Provider Demographics
NPI:1215394812
Name:HARRELL, JAMIE (BCBA)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HARRELL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 EASTBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1841
Mailing Address - Country:US
Mailing Address - Phone:410-474-8721
Mailing Address - Fax:
Practice Address - Street 1:7014 EASTBROOK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1841
Practice Address - Country:US
Practice Address - Phone:410-474-8721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst