Provider Demographics
NPI:1427875863
Name:HAYES, TASHEIKA M
Entity type:Individual
Prefix:
First Name:TASHEIKA
Middle Name:M
Last Name:HAYES
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 1:415 ARMOUR DR NE APT 2102
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3938
Mailing Address - Country:US
Mailing Address - Phone:904-485-2886
Mailing Address - Fax:904-485-2886
Practice Address - Street 1:415 ARMOUR DR NE APT 2102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3938
Practice Address - Country:US
Practice Address - Phone:904-485-2886
Practice Address - Fax:904-485-2886
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT23289804106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician