Provider Demographics
NPI:1710034335
Name:HAYES, DAVID L
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 SCHROCK RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1146
Mailing Address - Country:US
Mailing Address - Phone:614-888-8784
Mailing Address - Fax:614-888-9086
Practice Address - Street 1:1105 SCHROCK RD
Practice Address - Street 2:SUITE 207
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1146
Practice Address - Country:US
Practice Address - Phone:614-888-8784
Practice Address - Fax:614-888-9086
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3240103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical