Healthcare Provider Details

I. General information

NPI: 1548709785
Provider Name (Legal Business Name): DENISE ANN HAYS MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17343 171ST AVE S
SPRING VALLEY MN
55975
US

IV. Provider business mailing address

17343 171ST AVE
SPRING VALLEY MN
55975
US

V. Phone/Fax

Practice location:
  • Phone: 507-251-5458
  • Fax:
Mailing address:
  • Phone: 507-251-5458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number04950
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: