Provider Demographics
NPI:1952505372
Name:HAYES, KATHRYN RUTH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RUTH
Last Name:HAYES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PROCHNOW RD
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4861
Mailing Address - Country:US
Mailing Address - Phone:512-858-2852
Mailing Address - Fax:
Practice Address - Street 1:555 FM 3237
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5311
Practice Address - Country:US
Practice Address - Phone:512-847-5540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14373235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX455917Medicare ID - Type Unspecified