Provider Demographics
NPI:1063883379
Name:HAYES-DIGES, AUTUMN TENNILLE (MSLP, CCC-SLP, ATP)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:TENNILLE
Last Name:HAYES-DIGES
Suffix:
Gender:F
Credentials:MSLP, CCC-SLP, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 S. UNION
Mailing Address - Street 2:SUITE 255
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3126
Mailing Address - Country:US
Mailing Address - Phone:719-305-8217
Mailing Address - Fax:719-305-8001
Practice Address - Street 1:175 S UNION BLVD
Practice Address - Street 2:SUITE 255
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3113
Practice Address - Country:US
Practice Address - Phone:719-305-8000
Practice Address - Fax:719-305-8001
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP0000333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist