Provider Demographics
NPI:1043875743
Name:DUBOIS, HAILEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BURKE LN
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-9565
Mailing Address - Country:US
Mailing Address - Phone:413-575-8425
Mailing Address - Fax:
Practice Address - Street 1:200 KENDALL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2532
Practice Address - Country:US
Practice Address - Phone:413-737-4756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist