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General NPI Number Information
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NPI Number | 1902420276
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Entity Type | Individual
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Provider Name | JENNIFER MARIAH HALEY
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Gender | Female
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 3575 MACON RD STE 22
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City | COLUMBUS
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State | GA
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Zip | 31907-8200
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Country | US
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Telephone | 706-339-5928
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 SPRING CREEK LANE
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City | BILLINGS
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State | MT
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Zip | 59102
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Country | US
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Telephone | 406-373-3500
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 28900
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License Number State | MN
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