Provider Demographics
NPI:1811281454
Name:HILLMAN, JASON
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:HILLMAN
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 1:2704 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2707
Mailing Address - Country:US
Mailing Address - Phone:580-430-8111
Mailing Address - Fax:
Practice Address - Street 1:2704 TEXAS ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2707
Practice Address - Country:US
Practice Address - Phone:580-430-8111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional