Provider Demographics
NPI:1255018057
Name:DOCEA, JAMIE ALEXA
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ALEXA
Last Name:DOCEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5131 EXPO DR APT 201
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-8388
Mailing Address - Country:US
Mailing Address - Phone:740-503-9193
Mailing Address - Fax:
Practice Address - Street 1:245 N METRO DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8572
Practice Address - Country:US
Practice Address - Phone:920-903-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health