Individual
JASON MARK HALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
CALLE 3 VILLA BORINQUEN, VIEQUES, PR 00765
(817) 751-2066
Mailing address
PO BOX 878, VIEQUES, PR 00765-0878
(817) 751-2066
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13990
TX
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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