Provider Demographics
NPI:1841535960
Name:JAMISON, TAMURA M
Entity type:Individual
Prefix:MRS
First Name:TAMURA
Middle Name:M
Last Name:JAMISON
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 1:1116 E EL CAMPO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-4409
Mailing Address - Country:US
Mailing Address - Phone:702-273-6209
Mailing Address - Fax:
Practice Address - Street 1:1116 E EL CAMPO GRANDE AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4409
Practice Address - Country:US
Practice Address - Phone:702-273-6209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst