Provider Demographics
NPI:1790118750
Name:AITCHESON, JENNIFER ELIZABETH (MAOM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:AITCHESON
Suffix:
Gender:F
Credentials:MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 NW 12TH AVE.
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-547-6800
Mailing Address - Fax:
Practice Address - Street 1:5860 NW 44TH ST
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-6168
Practice Address - Country:US
Practice Address - Phone:954-610-5169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator