Provider Demographics
NPI:1164884425
Name:PIERRE HAYES, MELINA
Entity Type:Individual
Prefix:
First Name:MELINA
Middle Name:
Last Name:PIERRE HAYES
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 1:502 CARRIAGE WALK CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-5925
Mailing Address - Country:US
Mailing Address - Phone:404-512-0781
Mailing Address - Fax:
Practice Address - Street 1:502 CARRIAGE WALK CT
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-5925
Practice Address - Country:US
Practice Address - Phone:404-512-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072609-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker