Provider Demographics
NPI:1619387362
Name:CROWLEY-ZALAKET, JAIME GAIL (PHD)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:GAIL
Last Name:CROWLEY-ZALAKET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:GAIL
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:888 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1898
Mailing Address - Country:US
Mailing Address - Phone:848-800-8518
Mailing Address - Fax:
Practice Address - Street 1:888 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1898
Practice Address - Country:US
Practice Address - Phone:848-800-8518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-03
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
NJ1-14-17057103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist