Provider Demographics
NPI:1962495226
Name:HAYES, TERRY ALAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALAN
Last Name:HAYES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:769 PLAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2118
Mailing Address - Country:US
Mailing Address - Phone:781-837-5344
Mailing Address - Fax:781-837-5384
Practice Address - Street 1:769 PLAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2118
Practice Address - Country:US
Practice Address - Phone:781-837-5344
Practice Address - Fax:781-837-5384
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA3821103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0515779Medicaid
MA0515779Medicaid