Provider Demographics
NPI:1801158688
Name:HAYES, CARRIE LEE (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LEE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 STILLWATER TRL
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4305
Mailing Address - Country:US
Mailing Address - Phone:615-891-9131
Mailing Address - Fax:
Practice Address - Street 1:130 STILLWATER TRL
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4305
Practice Address - Country:US
Practice Address - Phone:615-891-9131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP000003975235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist