Provider Demographics
NPI:1487907226
Name:HOOGENDOORN, HALEY D (CMII)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:D
Last Name:HOOGENDOORN
Suffix:
Gender:F
Credentials:CMII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2316 N INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2942
Mailing Address - Country:US
Mailing Address - Phone:405-801-2817
Mailing Address - Fax:405-801-2071
Practice Address - Street 1:2316 N INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2942
Practice Address - Country:US
Practice Address - Phone:405-801-2817
Practice Address - Fax:405-801-2071
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200253070BMedicaid