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General NPI Number Information
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NPI Number | 1306389978
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Entity Type | Individual
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Provider Name | KENYA HAYLES
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Gender | Female
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 331 E MAIN ST
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City | ROCK HILL
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State | SC
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Zip | 29730-5383
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Country | US
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Telephone | 704-497-8594
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Fax | 855-345-0943
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Provider Business Mailing Address
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Address Line | 5115 FICUS TREE LN
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City | CHARLOTTE
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State | NC
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Zip | 28215-4384
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Country | US
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Telephone | 704-497-8594
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Fax | 855-345-0943
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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