Provider Demographics
NPI:1639210073
Name:HAYNOS, JUDITH E (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:HAYNOS
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W UNIVERSITY PKWY
Mailing Address - Street 2:APT J2
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-3432
Mailing Address - Country:US
Mailing Address - Phone:443-799-5226
Mailing Address - Fax:410-955-7885
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 2-109
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:443-287-3427
Practice Address - Fax:410-955-7885
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist