Provider Demographics
NPI:1144764408
Name:ECHOLS, HAYLEY GODWIN (LPMT, CB-MT)
Entity Type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:GODWIN
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:LPMT, CB-MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6115 ABBOTTS BRIDGE RD
Mailing Address - Street 2:#2208
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4280 HICKORY FLAT HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6633
Practice Address - Country:US
Practice Address - Phone:770-345-2804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000156225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist