Provider Demographics
NPI:1972940997
Name:AAENSON, JASMINE RENEE (BSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:RENEE
Last Name:AAENSON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 S QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-4623
Mailing Address - Country:US
Mailing Address - Phone:918-407-5744
Mailing Address - Fax:
Practice Address - Street 1:821 S QUINCY AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4623
Practice Address - Country:US
Practice Address - Phone:918-407-5744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker