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Contact Information

HAZEL JAY
6714 HIGHWAY 85 # A
RIVERDALE, GA30274-2383
 Phone: 510-415-2089
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Art Therapist

221700000X
 

Behavior Analyst

103K00000X
Indicates primary specialty

NPI Profile & details for HAZEL JAY · (Female)

NPI # 1538930235
Status Active
Credentials
Entity Individual
Enumeration date 01/11/2024
Last updated 01/11/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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