Provider Demographics
NPI:1639871106
Name:TAUBER, JAMIE LEIGH (MS, TLLP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEIGH
Last Name:TAUBER
Suffix:
Gender:F
Credentials:MS, TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5999 REDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8816
Mailing Address - Country:US
Mailing Address - Phone:734-645-7274
Mailing Address - Fax:
Practice Address - Street 1:5999 REDSTONE CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8816
Practice Address - Country:US
Practice Address - Phone:734-645-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009923103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral