Provider Demographics
NPI:1942504691
Name:GHANY, JAMIE L (PHD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:GHANY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:L
Other - Last Name:GHANY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:7000 E GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13066-1131
Mailing Address - Country:US
Mailing Address - Phone:315-956-4236
Mailing Address - Fax:
Practice Address - Street 1:7000 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13066-1131
Practice Address - Country:US
Practice Address - Phone:315-956-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017558-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst