Provider Demographics
NPI:1790888337
Name:ADLER, JAMIE LEIGH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LEIGH
Last Name:ADLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 N GOLF GLN
Mailing Address - Street 2:UNIT H
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-8425
Mailing Address - Country:US
Mailing Address - Phone:608-241-2204
Mailing Address - Fax:
Practice Address - Street 1:WILLIAM S. MIDDLETON VETERANS MEMORIAL HOSPITAL (116)
Practice Address - Street 2:2500 OVERLOOK TERRACE
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2254
Practice Address - Country:US
Practice Address - Phone:608-280-7260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1785-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical