Provider Demographics
NPI:1083496780
Name:GOSSER, HAYLEY MCKENZIE
Entity Type:Individual
Prefix:MISS
First Name:HAYLEY
Middle Name:MCKENZIE
Last Name:GOSSER
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 1:4400 PRAIRIE XING APT 3105
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-3085
Mailing Address - Country:US
Mailing Address - Phone:469-879-6488
Mailing Address - Fax:
Practice Address - Street 1:200 N NEW MEXICO ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-6523
Practice Address - Country:US
Practice Address - Phone:214-851-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist