Provider Demographics
NPI:1083274641
Name:HAYMAN, MORGAN THOMAS (MED,CCC-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:THOMAS
Last Name:HAYMAN
Suffix:
Gender:F
Credentials:MED,CCC-SLP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:NICOLE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:69 LINDSEY LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-1702
Mailing Address - Country:US
Mailing Address - Phone:912-729-2294
Mailing Address - Fax:912-673-9457
Practice Address - Street 1:69 LINDSEY LANE
Practice Address - Street 2:SUITE A
Practice Address - City:ST MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-1702
Practice Address - Country:US
Practice Address - Phone:912-729-2294
Practice Address - Fax:912-673-9457
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011128235Z00000X
GAPCET002898235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003235436AMedicaid