Provider Demographics
NPI:1356097646
Name:PRIESSNITZ, HAYLEY NICOLE
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:NICOLE
Last Name:PRIESSNITZ
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 1:11813 E BROADWAY AVE APT E304
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6370
Mailing Address - Country:US
Mailing Address - Phone:815-210-0629
Mailing Address - Fax:
Practice Address - Street 1:227 W 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3611
Practice Address - Country:US
Practice Address - Phone:509-995-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician