Provider Demographics
NPI:1396508297
Name:TRAYLOR, HAILIE (PLPC)
Entity type:Individual
Prefix:
First Name:HAILIE
Middle Name:
Last Name:TRAYLOR
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 CORTES ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3242
Mailing Address - Country:US
Mailing Address - Phone:314-825-8464
Mailing Address - Fax:
Practice Address - Street 1:574 CORTES ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-3242
Practice Address - Country:US
Practice Address - Phone:314-825-8464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health