Provider Demographics
NPI:1679967517
Name:HAYS, STEFANIE ELIZABETH
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:ELIZABETH
Last Name:HAYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COVINGTON RD
Mailing Address - Street 2:APARTMENT C
Mailing Address - City:AVONDALE ESTATES
Mailing Address - State:GA
Mailing Address - Zip Code:30002-1329
Mailing Address - Country:US
Mailing Address - Phone:504-913-1617
Mailing Address - Fax:
Practice Address - Street 1:4 COVINGTON RD
Practice Address - Street 2:APT C
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1329
Practice Address - Country:US
Practice Address - Phone:504-913-1617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist