| Jaime Marra, Phd, Llc | |
|
4320 Deerwood Lake Pkwy Ste 101-108 Jacksonville FL 32216-1177 | |
| (904) 479-5120 | |
| Not Available |
| Full Name | Jaime Marra, Phd, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4320 Deerwood Lake Pkwy Ste 101-108, Jacksonville, Florida |
| Authorized Official Name and Position | Jaime Victoria Marra (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9044795120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaime Marra, Phd, Llc 4320 Deerwood Lake Pkwy Ste 101-108 Jacksonville FL 32216-1177 Ph: (904) 479-5120 | Jaime Marra, Phd, Llc 4320 Deerwood Lake Pkwy Ste 101-108 Jacksonville FL 32216-1177 Ph: (904) 479-5120 |
| NPI Number | 1245709559 |
|---|---|
| Provider Enumeration Date | 11/15/2018 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 8921497066 |
|---|---|
| Medicare Enrollment ID | O20211111001757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245709559 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jaime Marra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376845933 PECOS PAC ID: 5799902128 Enrollment ID: I20140808001069 |
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