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General NPI Number Information
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NPI Number | 1780759076
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Entity Type | Individual
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Provider Name | JEAN FRENKIL AYERS PSY D, PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 112 S CROSS ST FL 2
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City | CHESTERTOWN
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State | MD
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Zip | 21620-1549
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Country | US
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Telephone | 443-282-0481
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Fax |
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Provider Business Mailing Address
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Address Line | 112 S CROSS ST FL 2
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City | CHESTERTOWN
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State | MD
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Zip | 21620-1549
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Country | US
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Telephone | 443-282-0481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 02442
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | OA002811
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA054657
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 02442
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License Number State | MD
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