Provider Demographics
NPI:1083247167
Name:HAILES, DEVYN MCCALL
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:MCCALL
Last Name:HAILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1897 S 2740 E
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7110
Mailing Address - Country:US
Mailing Address - Phone:435-773-0006
Mailing Address - Fax:
Practice Address - Street 1:230 N 1680 E STE D1
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2576
Practice Address - Country:US
Practice Address - Phone:435-705-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-18
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty