Provider Demographics
NPI:1205343837
Name:HAYES, JOSEPH WILLIAM (MED BCBA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:HAYES
Suffix:
Gender:M
Credentials:MED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-7257
Mailing Address - Country:US
Mailing Address - Phone:269-625-0636
Mailing Address - Fax:269-250-8200
Practice Address - Street 1:9616 PORTAGE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-7257
Practice Address - Country:US
Practice Address - Phone:269-625-0636
Practice Address - Fax:269-250-8200
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst