Provider Demographics
NPI:1396417028
Name:JACOBS, HAYLEY F
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:F
Last Name:JACOBS
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 1:713 E MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5125
Mailing Address - Country:US
Mailing Address - Phone:575-825-5068
Mailing Address - Fax:
Practice Address - Street 1:713 E MAPLE LN
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-5125
Practice Address - Country:US
Practice Address - Phone:575-825-5068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst