Provider Demographics
NPI:1487846812
Name:ZUCKERMAN, JAIME SPINELL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:SPINELL
Last Name:ZUCKERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:SHANNON
Other - Last Name:SPINELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:950 E HAVERFORD RD
Mailing Address - Street 2:SUITE 306-B
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3850
Mailing Address - Country:US
Mailing Address - Phone:610-551-1819
Mailing Address - Fax:484-532-7782
Practice Address - Street 1:950 E HAVERFORD RD
Practice Address - Street 2:SUITE 306-B
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3850
Practice Address - Country:US
Practice Address - Phone:610-551-1819
Practice Address - Fax:484-532-7782
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist