Healthcare Provider Details

I. General information

NPI: 1881412468
Provider Name (Legal Business Name): BAYLA HAGAN MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAYLA SHINDLEDECKER CCC-SLP

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 GOOD DR
LANCASTER PA
17601-2426
US

IV. Provider business mailing address

34 KEYSTONE AVE
PAOLI PA
19301-1132
US

V. Phone/Fax

Practice location:
  • Phone: 717-406-3000
  • Fax:
Mailing address:
  • Phone: 724-422-7797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL018633
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: