Provider Demographics
NPI:1194121574
Name:MEADOWS, HAILE
Entity type:Individual
Prefix:
First Name:HAILE
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 N EISENHOWER DR APT A
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3109
Mailing Address - Country:US
Mailing Address - Phone:304-254-9610
Mailing Address - Fax:304-254-9099
Practice Address - Street 1:550 N EISENHOWER DR APT A
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3109
Practice Address - Country:US
Practice Address - Phone:304-254-9610
Practice Address - Fax:304-254-9099
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)