Provider Demographics
NPI:1902687742
Name:HAYES, QIASHA ANDREA
Entity type:Individual
Prefix:
First Name:QIASHA
Middle Name:ANDREA
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 1:110 KOEHLER AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-4845
Mailing Address - Country:US
Mailing Address - Phone:859-319-3577
Mailing Address - Fax:
Practice Address - Street 1:110 KOEHLER AVE APT 10
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:OH
Practice Address - Zip Code:45215-4845
Practice Address - Country:US
Practice Address - Phone:859-743-5052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUM855090172A00000X, 385HR2060X
3747P1801X, 376J00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No172A00000XOther Service ProvidersDriver
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker