Provider Demographics
NPI:1790324341
Name:THOMAS, HAILEY HICKERSON (MCD, SLP-CF)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:HICKERSON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MCD, SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HARMONY CT
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7075
Mailing Address - Country:US
Mailing Address - Phone:731-676-4632
Mailing Address - Fax:
Practice Address - Street 1:2 INNWOOD CIR STE A
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2490
Practice Address - Country:US
Practice Address - Phone:601-993-7171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist