Provider Demographics
NPI:1992082275
Name:HASSETT, DAVID C
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:HASSETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29795 S PINE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CATOOSA
Mailing Address - State:OK
Mailing Address - Zip Code:74015-6148
Mailing Address - Country:US
Mailing Address - Phone:918-520-0734
Mailing Address - Fax:
Practice Address - Street 1:1516 S BOSTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4003
Practice Address - Country:US
Practice Address - Phone:918-561-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional