Individual
JADE LAURYN-ASHLEE HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
111 E 12TH ST, ADA, OK 74820-6501
(580) 436-2690
Mailing address
905 W 24TH ST, ADA, OK 74820-8039
(361) 652-4670
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
972228945
UNITED HEALTHCARE
TX
Enumeration date
02/25/2019
Last updated
02/25/2019
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