Provider Demographics
NPI:1770769002
Name:HAYES, CHRISTOPHER DAVID
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DAVID
Last Name:HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4037 DAVIS RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-4627
Mailing Address - Country:US
Mailing Address - Phone:561-868-0626
Mailing Address - Fax:
Practice Address - Street 1:4037 DAVIS RD
Practice Address - Street 2:SUITE 10
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-4627
Practice Address - Country:US
Practice Address - Phone:561-868-0626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102X00000XBehavioral Health & Social Service ProvidersPoetry Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04162007OtherHUMAN PARTICIPANT PROTECT