Provider Demographics
NPI:1417406620
Name:STILLINGER, JAMIE OWENS (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:OWENS
Last Name:STILLINGER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3668 N WILLIAMSBURG COUNTY HWY
Mailing Address - Street 2:
Mailing Address - City:CADES
Mailing Address - State:SC
Mailing Address - Zip Code:29518-3009
Mailing Address - Country:US
Mailing Address - Phone:843-389-2125
Mailing Address - Fax:843-389-2126
Practice Address - Street 1:3668 N WILLIAMSBURG COUNTY HWY
Practice Address - Street 2:
Practice Address - City:CADES
Practice Address - State:SC
Practice Address - Zip Code:29518-3009
Practice Address - Country:US
Practice Address - Phone:843-389-2125
Practice Address - Fax:843-389-2126
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-16-23454103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst