Provider Demographics
NPI:1447886817
Name:KENNEDY, HAYLEY SHOOK (SLP)
Entity type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:SHOOK
Last Name:KENNEDY
Suffix:
Gender:F
Credentials: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 23
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-0023
Mailing Address - Country:US
Mailing Address - Phone:337-856-1964
Mailing Address - Fax:337-856-5272
Practice Address - Street 1:101 GUILLOT RD
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5832
Practice Address - Country:US
Practice Address - Phone:337-856-1964
Practice Address - Fax:337-856-5272
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7949235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty