Provider Demographics
NPI:1467605626
Name:HAYES, DEBORAH A (SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PORT HENRY
Mailing Address - State:NY
Mailing Address - Zip Code:12974-1441
Mailing Address - Country:US
Mailing Address - Phone:518-570-5520
Mailing Address - Fax:
Practice Address - Street 1:30 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PORT HENRY
Practice Address - State:NY
Practice Address - Zip Code:12974-1441
Practice Address - Country:US
Practice Address - Phone:518-570-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0093851235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist