Provider Demographics
NPI:1477169878
Name:HAYES, VILLIE A
Entity Type:Individual
Prefix:MRS
First Name:VILLIE
Middle Name:A
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 1:1065 MEDINA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5375
Mailing Address - Country:US
Mailing Address - Phone:330-596-1042
Mailing Address - Fax:330-532-0038
Practice Address - Street 1:7292 MEADOWHAVEN DR
Practice Address - Street 2:
Practice Address - City:CHIPPEWA LAKE
Practice Address - State:OH
Practice Address - Zip Code:44215-9805
Practice Address - Country:US
Practice Address - Phone:216-346-0829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator