Provider Demographics
NPI:1821736083
Name:HAYWARD, FELICIA (NRCMA)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:NRCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8445 MUNSON RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-2410
Mailing Address - Country:US
Mailing Address - Phone:440-354-9924
Mailing Address - Fax:440-205-1040
Practice Address - Street 1:8445 MUNSON RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2410
Practice Address - Country:US
Practice Address - Phone:440-354-9924
Practice Address - Fax:440-205-1040
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2864093Medicaid