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Organization

SPROUT PEDIATRIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HAYES OLIVER MS CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(270) 713-7311
Entity
Organization

Contact information

Practice address
323 E 5TH AVE, CALVERT CITY, KY 42029-7600
(270) 713-7311
(270) 713-7401
Mailing address
323 E 5TH AVE, CALVERT CITY, KY 42029-7600
(270) 713-7311
(270) 713-7401

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
08/25/2023
Last updated
04/24/2026
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