Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 519 | MN |
N | 103T00000X | Psychologist | 519 | MN |
NPI | 1003026006 |
---|---|
Provider Name | Dr. Mary Ann Hayes |
First Address | Golden Valley, MN 55427-4047 |
Second Address | Golden Valley, MN 55427-4562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |