Provider Demographics
NPI:1700842325
Name:MALPEDE, JAYNE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAYNE
Middle Name:M
Last Name:MALPEDE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5388 WELSFORD CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5818
Mailing Address - Country:US
Mailing Address - Phone:513-942-9512
Mailing Address - Fax:513-942-0756
Practice Address - Street 1:8080 BECKETT CENTER DR
Practice Address - Street 2:SUITE 313
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5026
Practice Address - Country:US
Practice Address - Phone:513-860-2313
Practice Address - Fax:513-860-4192
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6040103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2708270Medicaid
OH2708270Medicaid