Provider Demographics
NPI:1467704312
Name:EDGAR, JAMI R H (LSW)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:R H
Last Name:EDGAR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JAMI
Other - Middle Name:R
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:819 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6303
Mailing Address - Country:US
Mailing Address - Phone:609-452-2088
Mailing Address - Fax:
Practice Address - Street 1:819 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6303
Practice Address - Country:US
Practice Address - Phone:609-452-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05793500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker