Individual
KATHY HOLDER HAYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
702 BARNHILL DR, INDIANAPOLIS, IN 46202-5128
(317) 274-8162
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-4827
(317) 948-3078
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001238A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264430970
MEDICARE PTAN
IN
Enumeration date
03/10/2008
Last updated
04/08/2020
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