Provider Demographics
NPI:1568731966
Name:BAKER, HAYLEY (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 TOPEKA CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4739
Mailing Address - Country:US
Mailing Address - Phone:770-913-9334
Mailing Address - Fax:
Practice Address - Street 1:4850 TOPEKA CT
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-4739
Practice Address - Country:US
Practice Address - Phone:770-913-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist