Healthcare Provider Details

I. General information

NPI: 1861850927
Provider Name (Legal Business Name): JAMIE HUCKINS-BARKER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE HUCKINS

II. Dates (important events)

Enumeration Date: 02/04/2016
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD 116B(W)
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

10701 EAST BLVD 116B(W)
CLEVELAND OH
44106-1702
US

V. Phone/Fax

Practice location:
  • Phone: 216-719-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number7388
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: