Provider Demographics
NPI:1578098067
Name:HAYES, TALIA CUSANELLI
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:CUSANELLI
Last Name:HAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4268 LAKE WOODARD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1055
Mailing Address - Country:US
Mailing Address - Phone:919-702-4252
Mailing Address - Fax:
Practice Address - Street 1:4268 LAKE WOODARD DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1055
Practice Address - Country:US
Practice Address - Phone:919-702-4252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist