Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 2019012287 | MO |
NPI | 1003454182 |
---|---|
Provider Name | Heather Hayes |
First Address | Independence, MO 64051-0260 |
Second Address | Independence, MO 64057-1840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2019 |
Last Update Date | 19/12/2019 |