MEDICARE: HAYLEY EVANS MFTC

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	106H00000X	Marriage & Family Therapist	MFTC.0013943	CO

General Provider Information

NPI Number	:	1881345338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY EVANS MFTC

Provider Business Mailing Address
First Line	:	80 GARDEN CTR STE 137
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-2622
Country	:	US
Telephone Number	:	720-557-6978
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 GARDEN CTR STE 137
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-2622
Country	:	US
Telephone Number	:	720-557-6978
Fax Number	:

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

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/17/2022

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Directions to “ HAYLEY EVANS MFTC” Practice Location

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