Provider Demographics
NPI:1962233221
Name:HAGY, MAKAYLA LANE (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:LANE
Last Name:HAGY
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 1:1800 TRES DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5622
Mailing Address - Country:US
Mailing Address - Phone:903-850-0071
Mailing Address - Fax:
Practice Address - Street 1:1800 TRES DR
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:TX
Practice Address - Zip Code:75791-5622
Practice Address - Country:US
Practice Address - Phone:903-850-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120841235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty