Provider Demographics
NPI:1447055686
Name:BEARD-DAWDA, JAIMIE N (MA, NCSP, TLLP)
Entity type:Individual
Prefix:
First Name:JAIMIE
Middle Name:N
Last Name:BEARD-DAWDA
Suffix:
Gender:F
Credentials:MA, NCSP, TLLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8660 S MACKINAW TRL
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-9746
Mailing Address - Country:US
Mailing Address - Phone:248-931-9370
Mailing Address - Fax:
Practice Address - Street 1:8660 S MACKINAW TRL
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-9746
Practice Address - Country:US
Practice Address - Phone:248-931-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist