Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | CG60151631 | WA |
NPI | 1003147315 |
---|---|
Provider Name | Robert J Hayes |
First Address | Zillah, WA 98953-9414 |
Second Address | Zillah, WA 98953-9414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2010 |
Last Update Date | 31/08/2012 |