Healthcare Provider Details

I. General information

NPI: 1033505201
Provider Name (Legal Business Name): ANDREA HAYES HAIR LOSS SPEC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7127 ALLENTOWN RD STE 205
FT WASHINGTON MD
20744-1000
US

IV. Provider business mailing address

9618 INVERARY CT BRICK HEARTH CT
LORTON VA
22079-1911
US

V. Phone/Fax

Practice location:
  • Phone: 240-459-3062
  • Fax:
Mailing address:
  • Phone: 360-250-9721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: