MEDICARE: HAYLEIGH LAUREN HAID

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	101YM0800X	Mental Health Counselor	IMH26310

General Provider Information

NPI Number	:	1568284594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEIGH LAUREN HAID

Provider Business Mailing Address
First Line	:	43 KNIGHT BOXX RD STE 1
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-7395
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 CLAIRE LN STE 202
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-6665
Country	:	US
Telephone Number	:	904-379-8675
Fax Number	:

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

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	10/30/2024

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Directions to “ HAYLEIGH LAUREN HAID ” Practice Location

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