Provider Demographics
NPI:1841530292
Name:LAYWELL, MARY FRANCES (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:LAYWELL
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3712 SWALLOWTAIL TRCE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-7009
Mailing Address - Country:US
Mailing Address - Phone:850-765-8717
Mailing Address - Fax:
Practice Address - Street 1:1641 MAHAN CENTER BLVD STE 2
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7404
Practice Address - Country:US
Practice Address - Phone:850-222-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1235237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter