Provider Demographics
NPI:1316837297
Name:HAREN, JILLIAN AVA
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:AVA
Last Name:HAREN
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 1:29110 WELDONS FOREST CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5210
Mailing Address - Country:US
Mailing Address - Phone:346-624-1377
Mailing Address - Fax:
Practice Address - Street 1:28111 S FIRETHORNE RD STE 401
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0317
Practice Address - Country:US
Practice Address - Phone:281-971-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician