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General NPI Number Information
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NPI Number | 1518808997
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Entity Type | Individual
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Provider Name | MR. TERRY MAURICE JASPER JR.
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Gender | Male
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 3308 OASIS SPRINGS RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-2579
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Country | US
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Telephone | 808-489-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 95-061 KAULUA ST
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City | MILILANI
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State | HI
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Zip | 96789-1509
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Country | US
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Telephone | 808-489-3007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SWB-2024-0076
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License Number State | NM
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