Provider Demographics
NPI:1043209976
Name:HAYES, PATRICIA J (PSYD)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:J
Last Name:HAYES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 W ELMWOOD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4239
Mailing Address - Country:US
Mailing Address - Phone:937-436-0700
Mailing Address - Fax:937-424-5749
Practice Address - Street 1:77 W ELMWOOD DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4239
Practice Address - Country:US
Practice Address - Phone:937-436-0700
Practice Address - Fax:937-424-5749
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4580103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical