Provider Demographics
NPI:1881901361
Name:WALTON, JAIMA ELIZABETH (PSYD)
Entity type:Individual
Prefix:
First Name:JAIMA
Middle Name:ELIZABETH
Last Name:WALTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9129 CROSS PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4505
Mailing Address - Country:US
Mailing Address - Phone:865-983-1899
Mailing Address - Fax:865-409-5939
Practice Address - Street 1:9129 CROSS PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4505
Practice Address - Country:US
Practice Address - Phone:658-983-1899
Practice Address - Fax:865-409-5939
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP3063103T00000X
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program