Provider Demographics
NPI:1841087210
Name:JILAJIAN, SKYE
Entity type:Individual
Prefix:
First Name:SKYE
Middle Name:
Last Name:JILAJIAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 663
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-0663
Mailing Address - Country:US
Mailing Address - Phone:856-220-9903
Mailing Address - Fax:
Practice Address - Street 1:4 WHITNEY PL
Practice Address - Street 2:
Practice Address - City:HAINESPORT
Practice Address - State:NJ
Practice Address - Zip Code:08036-6251
Practice Address - Country:US
Practice Address - Phone:856-220-9903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst