Provider Demographics
NPI:1720754872
Name:GRAINGER, JAIME (MFTC)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 HAMPSTEAD DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5221
Mailing Address - Country:US
Mailing Address - Phone:574-993-1776
Mailing Address - Fax:
Practice Address - Street 1:2855 N SPEER BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4239
Practice Address - Country:US
Practice Address - Phone:720-445-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist