Provider Demographics
NPI:1730723016
Name:HAYS, AMANDA LEE (CCCC-SLP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:HAYS
Suffix:
Gender:F
Credentials:CCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 MOSSY BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7063
Mailing Address - Country:US
Mailing Address - Phone:256-499-9278
Mailing Address - Fax:
Practice Address - Street 1:129 MOSSY BRANCH DR
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7063
Practice Address - Country:US
Practice Address - Phone:256-499-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist