Provider Demographics
NPI:1093004632
Name:HAYES, KELLEY M (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:M
Last Name:HAYES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COMMONS DR # F
Mailing Address - Street 2:SUITE 38
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3441
Mailing Address - Country:US
Mailing Address - Phone:603-437-3330
Mailing Address - Fax:603-437-0431
Practice Address - Street 1:1 COMMONS DR # F
Practice Address - Street 2:SUITE 38
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3441
Practice Address - Country:US
Practice Address - Phone:603-437-3330
Practice Address - Fax:603-437-0431
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist