Healthcare Provider Details

I. General information

NPI: 1306427596
Provider Name (Legal Business Name): HAYLEY N FRUCHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9316 LOUETTA RD
SPRING TX
77379-6520
US

IV. Provider business mailing address

23902 KUYKENDAHL RD APT 4222
TOMBALL TX
77375-5709
US

V. Phone/Fax

Practice location:
  • Phone: 713-962-4599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: