Provider Demographics
NPI:1669907655
Name:DEQUINZIO, JAIME ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ANN
Last Name:DEQUINZIO
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ASCOT LN
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2869
Mailing Address - Country:US
Mailing Address - Phone:862-266-4510
Mailing Address - Fax:
Practice Address - Street 1:8 ASCOT LN
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2869
Practice Address - Country:US
Practice Address - Phone:862-266-4510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100667400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist