Healthcare Provider Details

I. General information

NPI: 1295404358
Provider Name (Legal Business Name): MICHAEL ARCHIE HAYS M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W BROADWAY
MOUNTAINAIR NM
87036
US

IV. Provider business mailing address

PO BOX 897
MOUNTAINAIR NM
87036
US

V. Phone/Fax

Practice location:
  • Phone: 505-847-2320
  • Fax:
Mailing address:
  • Phone: 505-358-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: