Provider Demographics
NPI:1225370455
Name:HAYES, ANTHONY T (AS)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:T
Last Name:HAYES
Suffix:
Gender:M
Credentials:AS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1440 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1236
Mailing Address - Country:US
Mailing Address - Phone:610-644-6464
Mailing Address - Fax:610-889-0732
Practice Address - Street 1:32 REGENCY PLZ
Practice Address - Street 2:871 BALTIMORE PIKE
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1001
Practice Address - Country:US
Practice Address - Phone:610-644-6464
Practice Address - Fax:610-889-0732
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)