Provider Demographics
NPI:1598827545
Name:HAYES, JILL HATHAWAY (MA)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:HATHAWAY
Last Name:HAYES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:HATHAWAY
Other - Last Name:BOURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, ATR
Mailing Address - Street 1:1405 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4608
Mailing Address - Country:US
Mailing Address - Phone:502-896-0495
Mailing Address - Fax:
Practice Address - Street 1:1405 BROWNS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4608
Practice Address - Country:US
Practice Address - Phone:502-896-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist