| Doctor Name: | DR. JASON B DELEEUW |
| NPI Number: | 1992852453 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 1052 |
| Business Practice Address: | 650 Joel Dr. Blanchfield Army Community Hospital Ft. Campbell, KY - 422235349 |
| Business Phone Number: | 2707988727 |
| Business Fax Number: | 2709560180 |
| Mailing Address: | 650 Joel Dr., Blanchfield Army Community Hospital FT. CAMPBELL |
| State: | KY |
| Postal Code: | 422235349 |
| Phone Number: | 2707988727 |
| Fax Number: | 2709560180 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1052 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |