Provider Demographics
NPI:1285829846
Name:CAPOROSSI, JAIMIE MARIE
Entity Type:Individual
Prefix:MISS
First Name:JAIMIE
Middle Name:MARIE
Last Name:CAPOROSSI
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 1:345 BUCKLAND HILLS DR
Mailing Address - Street 2:APT # 16233
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-8704
Mailing Address - Country:US
Mailing Address - Phone:203-824-0939
Mailing Address - Fax:
Practice Address - Street 1:345 BUCKLAND HILLS DR
Practice Address - Street 2:APT # 16233
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-8704
Practice Address - Country:US
Practice Address - Phone:203-824-0939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor