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NPI Code Detail

MEDICARE: JACQUES M AYI-BAMAH

MEDICARE: JACQUES M AYI-BAMAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1518442573
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUES M AYI-BAMAH
Provider Business Mailing Address
First Line : 1600 LIBERTY PL
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-5705
Country : US
Telephone Number : 856-861-5448
Fax Number :
Provider Business Practice Location Address
First Line : 1600 LIBERTY PL
Second Line :
City : SICKLERVILLE
State : NJ
Zip : 08081-5705
Country : US
Telephone Number : 856-861-5448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2018
Last Update Date : 09/26/2018

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