Provider Demographics
NPI:1275758930
Name:JAIME, MICHAELE DEE (EDD)
Entity Type:Individual
Prefix:DR
First Name:MICHAELE
Middle Name:DEE
Last Name:JAIME
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14213 W ASTER DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5505
Mailing Address - Country:US
Mailing Address - Phone:602-242-0281
Mailing Address - Fax:
Practice Address - Street 1:3801 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-2133
Practice Address - Country:US
Practice Address - Phone:602-242-0281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool