Provider Demographics
NPI:1629745302
Name:MOORE-HAYES, SHALIA L (PSY S, NASP)
Entity Type:Individual
Prefix:
First Name:SHALIA
Middle Name:L
Last Name:MOORE-HAYES
Suffix:
Gender:F
Credentials:PSY S, NASP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10205 36TH CT E
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2023
Mailing Address - Country:US
Mailing Address - Phone:319-504-1899
Mailing Address - Fax:
Practice Address - Street 1:10205 36TH CT E
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:FL
Practice Address - Zip Code:34219-2023
Practice Address - Country:US
Practice Address - Phone:319-504-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty