Provider Demographics
NPI:1629212410
Name:SIEGEL, JAMIE NICOLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:NICOLE
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 PLAINSBORO ROAD
Mailing Address - Street 2:BUILDING 100, SUITE F
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536
Mailing Address - Country:US
Mailing Address - Phone:609-297-5067
Mailing Address - Fax:617-663-6366
Practice Address - Street 1:666 PLAINSBORO ROAD
Practice Address - Street 2:BUILDING 100, SUITE F
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:609-297-5067
Practice Address - Fax:617-663-6366
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00599800103TC0700X
MA9674103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical