Provider Demographics
NPI:1528687548
Name:SMITH, HAILEY DEANN
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:DEANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 FREEDOM RD UNIT 528
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-2184
Mailing Address - Country:US
Mailing Address - Phone:817-233-1085
Mailing Address - Fax:
Practice Address - Street 1:401 S DEWEY AVE STE 108
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3525
Practice Address - Country:US
Practice Address - Phone:918-336-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical