Provider Demographics
NPI:1467288837
Name:WARE, HAYLEY (LMBT)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 WILLIAM VICKERS AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2792
Mailing Address - Country:US
Mailing Address - Phone:919-229-9555
Mailing Address - Fax:
Practice Address - Street 1:607 WILLIAM VICKERS AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2792
Practice Address - Country:US
Practice Address - Phone:919-229-9555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19480225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist