Provider Demographics
NPI:1992149983
Name:HAYWARD, ALLISON RENE (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RENE
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:MISS
Other - First Name:ALLISON
Other - Middle Name:RENE
Other - Last Name:COTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:8625 PISA DR APT 1123
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-2145
Mailing Address - Country:US
Mailing Address - Phone:765-721-7855
Mailing Address - Fax:
Practice Address - Street 1:8625 PISA DR APT 1123
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-2145
Practice Address - Country:US
Practice Address - Phone:765-721-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI09881225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist