Provider Demographics
NPI:1013278894
Name:ANNA HAYES, SPEECH THERAPIST INC
Entity Type:Organization
Organization Name:ANNA HAYES, SPEECH THERAPIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MILLICENT
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:719-337-0924
Mailing Address - Street 1:487 POTLATCH TRL
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-7820
Mailing Address - Country:US
Mailing Address - Phone:719-337-0924
Mailing Address - Fax:
Practice Address - Street 1:487 POTLATCH TRL
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-7820
Practice Address - Country:US
Practice Address - Phone:719-337-0924
Practice Address - Fax:855-206-2879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12019365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12019365OtherASHA NUMBER
CO23028874Medicaid