Healthcare Provider Details

I. General information

NPI: 1265365241
Provider Name (Legal Business Name): CHRISTINE RENEE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 LAUREL RD
YEADON PA
19050-3609
US

IV. Provider business mailing address

804 LAUREL RD
YEADON PA
19050-3609
US

V. Phone/Fax

Practice location:
  • Phone: 610-324-7371
  • Fax: 610-622-4657
Mailing address:
  • Phone: 610-324-7371
  • Fax: 610-622-4657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPCO20084
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: