Provider Demographics
NPI:1467055079
Name:ELIZABETH HAILS, SLP, LLC
Entity Type:Organization
Organization Name:ELIZABETH HAILS, SLP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAILS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-503-6882
Mailing Address - Street 1:3574 TURTLE COVE CT SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4317
Mailing Address - Country:US
Mailing Address - Phone:317-503-6882
Mailing Address - Fax:
Practice Address - Street 1:3574 TURTLE COVE CT SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4317
Practice Address - Country:US
Practice Address - Phone:317-503-6882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty