Provider Demographics
NPI:1912520701
Name:HAYNES, MORGAN HARMON (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:HARMON
Last Name:HAYNES
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-2338
Mailing Address - Country:US
Mailing Address - Phone:423-718-5751
Mailing Address - Fax:
Practice Address - Street 1:1600 HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:ROSSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30741-2210
Practice Address - Country:US
Practice Address - Phone:706-866-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003235696BMedicaid