Healthcare Provider Details

I. General information

NPI: 1497064828
Provider Name (Legal Business Name): MRS. WENDY LUREE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2010
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16500 PIERCE FERRY RD
DOLAN SPRINGS AZ
86441
US

IV. Provider business mailing address

PO BOX 248
DOLAN SPRINGS AZ
86441-0248
US

V. Phone/Fax

Practice location:
  • Phone: 928-767-3350
  • Fax:
Mailing address:
  • Phone: 928-767-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: