Provider Demographics
NPI:1992143945
Name:FITE, JAYME D (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:D
Last Name:FITE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2189 E SUFFOLK DR
Mailing Address - Street 2:
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-7406
Mailing Address - Country:US
Mailing Address - Phone:928-965-4691
Mailing Address - Fax:
Practice Address - Street 1:2189 E SUFFOLK DR
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-7406
Practice Address - Country:US
Practice Address - Phone:928-965-4691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5408224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant