Basic Information
| Provider Information | |||||||||
| NPI: | 1184052557 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PROANO | ||||||||
| FirstName: | JAYME | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A., L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 197 PARK AVE | ||||||||
| Address2: | |||||||||
| City: | NUTLEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071102806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738090325 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 610 VALLEY HEALTH PLZ | ||||||||
| Address2: | |||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012658200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2013 | ||||||||
| LastUpdateDate: | 03/02/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 37PC00574100 | NJ | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.