Provider Demographics
NPI:1750651709
Name:WEBBER, JAIME LYNN (MS)
Entity Type:Individual
Prefix:MISS
First Name:JAIME
Middle Name:LYNN
Last Name:WEBBER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 GARDEN CITY PLAZA
Mailing Address - Street 2:SUITE 350
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-747-9030
Mailing Address - Fax:516-877-0998
Practice Address - Street 1:300 GARDEN CITY PLAZA
Practice Address - Street 2:SUITE 350
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-747-9030
Practice Address - Fax:516-877-0998
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY452508101103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst