Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 20090015A | IN |
Y | 103T00000X | Psychologist | 20090015A | IN |
NPI | 1003886524 |
---|---|
Provider Name | Dr. Robert E Hayes |
First Address | Anderson, IN 46017-9689 |
Second Address | Muncie, IN 47304-4371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S00941 | (02) | IN |