Provider Demographics
NPI:1518287762
Name:BEAN, HAYES (MS OTR/L)
Entity Type:Individual
Prefix:MR
First Name:HAYES
Middle Name:
Last Name:BEAN
Suffix:
Gender:M
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10075 WILLMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERSET
Mailing Address - State:SD
Mailing Address - Zip Code:57718-6704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10075 WILLMINGTON DR
Practice Address - Street 2:
Practice Address - City:SUMMERSET
Practice Address - State:SD
Practice Address - Zip Code:57718-6704
Practice Address - Country:US
Practice Address - Phone:605-210-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist