Provider Demographics
NPI:1922486174
Name:BEST, HAILES DENISE PHANELLA
Entity Type:Individual
Prefix:
First Name:HAILES
Middle Name:DENISE PHANELLA
Last Name:BEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 BRUCKNER BLVD APT 3D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-6437
Mailing Address - Country:US
Mailing Address - Phone:347-898-6644
Mailing Address - Fax:
Practice Address - Street 1:1591 BRUCKNER BLVD APT 3D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-6437
Practice Address - Country:US
Practice Address - Phone:347-898-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist