Provider Demographics
NPI:1699930750
Name:HAYES, JERRI LYNNE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:JERRI
Middle Name:LYNNE
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:PO BOX 1784
Mailing Address - Street 2:4515 THRELKEL FERRY RD.
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-1784
Mailing Address - Country:US
Mailing Address - Phone:270-791-1663
Mailing Address - Fax:270-842-0735
Practice Address - Street 1:4515 THRELKEL FERRY RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-8907
Practice Address - Country:US
Practice Address - Phone:270-791-1663
Practice Address - Fax:270-842-0735
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2990235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist