MEDICARE: DR. MARI K HAYES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PYT0063	MO
2	103T00000X	Psychologist	2005028847	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	83355	OTHER	AR	ARK BLUE SHIELD

General Provider Information

NPI Number	:	1396887154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARI K HAYES PHD

Provider Business Mailing Address
First Line	:	6306 WALNUT ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2314
Country	:	US
Telephone Number	:	734-673-0082
Fax Number	:

Provider Business Practice Location Address
First Line	:	6306 WALNUT ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2314
Country	:	US
Telephone Number	:	734-673-0082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	05/14/2024

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