Provider Demographics
NPI:1891226866
Name:HAYES, BRANDI (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
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:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:COMBS
Mailing Address - State:KY
Mailing Address - Zip Code:41729-0075
Mailing Address - Country:US
Mailing Address - Phone:606-260-3153
Mailing Address - Fax:
Practice Address - Street 1:104 BAILEY ST
Practice Address - Street 2:
Practice Address - City:COMBS
Practice Address - State:KY
Practice Address - Zip Code:41729
Practice Address - Country:US
Practice Address - Phone:606-260-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY165220225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist