Provider Demographics
NPI:1487356523
Name:HAYES, KATHERINE JEANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:JEANNE
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W 1ST ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1150
Mailing Address - Country:US
Mailing Address - Phone:937-951-3077
Mailing Address - Fax:937-951-3109
Practice Address - Street 1:118 W 1ST ST STE 1000
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1150
Practice Address - Country:US
Practice Address - Phone:193-795-1307
Practice Address - Fax:937-951-3109
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08437103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical