Provider Demographics
NPI:1730317280
Name:HAIUM, JASON BRUCE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRUCE
Last Name:HAIUM
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BUSINESS WAY
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401
Mailing Address - Country:US
Mailing Address - Phone:540-886-5777
Mailing Address - Fax:540-886-5776
Practice Address - Street 1:102 BUSINESS WAY
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401
Practice Address - Country:US
Practice Address - Phone:540-886-5777
Practice Address - Fax:540-886-5776
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004128103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical