Provider Demographics
NPI:1902785801
Name:HAYCOX, LEAH (LMT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HAYCOX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1792 E JOYCE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5253
Mailing Address - Country:US
Mailing Address - Phone:479-312-7108
Mailing Address - Fax:
Practice Address - Street 1:1792 E JOYCE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5253
Practice Address - Country:US
Practice Address - Phone:479-312-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1616808225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist