Provider Demographics
NPI:1285032631
Name:STOVERING, JAIME (PSYD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:STOVERING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 MADISON RD
Mailing Address - Street 2:1610
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2751 O'VARSITY WAY
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45221-0010
Practice Address - Country:US
Practice Address - Phone:513-556-2564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-17
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7048103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical