Provider Demographics
NPI:1891395026
Name:NASRALLAH, HAYLEY (MA)
Entity Type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:
Last Name:NASRALLAH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:OOSTHUYSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 ALBEMARLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4716
Mailing Address - Country:US
Mailing Address - Phone:540-227-0045
Mailing Address - Fax:540-779-7499
Practice Address - Street 1:223 ALBEMARLE AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4716
Practice Address - Country:US
Practice Address - Phone:540-227-0045
Practice Address - Fax:540-779-7499
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8702101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional