Provider Demographics
NPI:1346487394
Name:MILFORD, JAIME LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:LYNNE
Last Name:MILFORD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11707 CLUB DR
Mailing Address - Street 2:JAHVA OUTPATIENT CENTER (116B)
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5521
Mailing Address - Country:US
Mailing Address - Phone:813-631-7135
Mailing Address - Fax:813-631-7128
Practice Address - Street 1:11707 CLUB DR
Practice Address - Street 2:JAHVA OUTPATIENT CENTER (116B)
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5521
Practice Address - Country:US
Practice Address - Phone:813-631-7135
Practice Address - Fax:813-631-7128
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical