Provider Demographics
NPI:1003577842
Name:HAYES, REBECCA E (LMT)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:E
Last Name:HAYES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 PASEO DEL PUEBLO SUR # 173
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-7231
Mailing Address - Country:US
Mailing Address - Phone:575-999-1395
Mailing Address - Fax:
Practice Address - Street 1:187D UNIT 6, TRES PIEDRAS ESTATES
Practice Address - Street 2:187 LOT D, UNIT 6
Practice Address - City:TRES PIEDRAS
Practice Address - State:NM
Practice Address - Zip Code:87577
Practice Address - Country:US
Practice Address - Phone:575-999-1395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT9540225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty