Provider Demographics
NPI:1689359523
Name:MAYES, JAMIE BERNARD (BT)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:BERNARD
Last Name:MAYES
Suffix:
Gender:M
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 KINSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-1411
Mailing Address - Country:US
Mailing Address - Phone:443-589-4274
Mailing Address - Fax:
Practice Address - Street 1:2728 KINSEY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1411
Practice Address - Country:US
Practice Address - Phone:443-589-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician