Provider Demographics
NPI:1508664061
Name:HAYES, BRYNN RENAE I (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:BRYNN
Middle Name:RENAE
Last Name:HAYES
Suffix:I
Gender:
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4965 COUNTY ROAD 2130
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65259-2628
Mailing Address - Country:US
Mailing Address - Phone:660-998-0458
Mailing Address - Fax:
Practice Address - Street 1:4965 COUNTY ROAD 2130
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65259-2628
Practice Address - Country:US
Practice Address - Phone:660-998-0458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011001341224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant