Basic Information
| Provider Information | |||||||||
| NPI: | 1487977179 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PATRICE D. HAY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 SANDHILL CRANE RUN | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328288433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075754695 | ||||||||
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| Practice Location | |||||||||
| Address1: | 220 SANDHILL CRANE RUN | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328288433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4075754695 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2010 | ||||||||
| LastUpdateDate: | 03/09/2010 | ||||||||
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| AuthorizedOfficialLastName: | HAY | ||||||||
| AuthorizedOfficialFirstName: | PATRICE | ||||||||
| AuthorizedOfficialMiddleName: | DOROTHY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/BEHAVIOR ANALYST | ||||||||
| AuthorizedOfficialTelephone: | 4075754695 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BCABA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.