Provider Demographics
NPI:1316107956
Name:HAYES, ANITA L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:L
Last Name:HAYES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 PASEO NUEVO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5796
Mailing Address - Country:US
Mailing Address - Phone:915-342-3399
Mailing Address - Fax:866-330-1652
Practice Address - Street 1:12200 PASEO NUEVO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-5796
Practice Address - Country:US
Practice Address - Phone:915-342-3399
Practice Address - Fax:866-330-1652
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist