Provider Demographics
NPI:1801187042
Name:BAYS, LISA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:BAYS
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 1:7605 HIGHWAY 577 E
Mailing Address - Street 2:
Mailing Address - City:TYNER
Mailing Address - State:KY
Mailing Address - Zip Code:40486-8009
Mailing Address - Country:US
Mailing Address - Phone:606-364-3072
Mailing Address - Fax:
Practice Address - Street 1:7605 HIGHWAY 577 E
Practice Address - Street 2:
Practice Address - City:TYNER
Practice Address - State:KY
Practice Address - Zip Code:40486-8009
Practice Address - Country:US
Practice Address - Phone:606-364-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist