Provider Demographics
NPI:1043545775
Name:HAYES, LANETA PUGH (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LANETA
Middle Name:PUGH
Last Name:HAYES
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 W END BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-2230
Mailing Address - Country:US
Mailing Address - Phone:504-481-7272
Mailing Address - Fax:
Practice Address - Street 1:5154 BAYOU BLVD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2102
Practice Address - Country:US
Practice Address - Phone:850-416-4933
Practice Address - Fax:850-416-7348
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
LA2963235Z00000X
FLSA8392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist