Provider Demographics
NPI:1750065298
Name:STEEN, JAYDA
Entity type:Individual
Prefix:
First Name:JAYDA
Middle Name:
Last Name:STEEN
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 1:2618 HOLMES RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-3505
Mailing Address - Country:US
Mailing Address - Phone:951-821-0268
Mailing Address - Fax:
Practice Address - Street 1:16 SAGO PALM DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9504
Practice Address - Country:US
Practice Address - Phone:951-821-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst