Provider Demographics
NPI:1992884233
Name:HAYES, MELISSA LEIGH (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:HAYES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LEIGH
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:475 IRVIN CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1717
Mailing Address - Country:US
Mailing Address - Phone:404-299-6600
Mailing Address - Fax:
Practice Address - Street 1:475 IRVIN CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1717
Practice Address - Country:US
Practice Address - Phone:404-299-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP 005737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA635702093AMedicaid