Provider Demographics
NPI:1124683446
Name:HAYLEY, RENEE (CPSW)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HAYLEY
Suffix:
Gender:F
Credentials:CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 ZAFARANO DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2669
Mailing Address - Country:US
Mailing Address - Phone:505-466-5885
Mailing Address - Fax:505-466-5886
Practice Address - Street 1:3450 ZAFARANO DR UNIT C
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2669
Practice Address - Country:US
Practice Address - Phone:505-466-5885
Practice Address - Fax:505-466-5886
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator