Provider Demographics
NPI:1326226390
Name:HAYES, DONNA SUE
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:SUE
Last Name: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 1:2961 CONCORD LANE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-3119
Mailing Address - Country:US
Mailing Address - Phone:907-344-2729
Mailing Address - Fax:907-677-1105
Practice Address - Street 1:2961 CONCORD LANE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-3119
Practice Address - Country:US
Practice Address - Phone:907-344-2729
Practice Address - Fax:907-677-1105
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100295251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health