Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 104100000X | Social Worker | 7155 | OK |
NPI | 1013250414 |
---|---|
Provider Name | Jasmine Lanae Hayes |
First Address | Tulsa, OK 74114-3301 |
Second Address | Tulsa, OK 74114-3301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 12/05/2021 |