Healthcare Provider Details

I. General information

NPI: 1376024539
Provider Name (Legal Business Name): VALERIE L HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2018
Last Update Date: 08/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E AVE J
LAMPASAS TX
76550-1211
US

IV. Provider business mailing address

239 CHICKADEE LN
LEANDER TX
78641-2704
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-6267
  • Fax:
Mailing address:
  • Phone: 512-587-7349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number210047
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: