Provider Demographics
NPI:1154218857
Name:SLACK, HALEY (AUD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:SLACK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2660 E CHESTER DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1364
Mailing Address - Country:US
Mailing Address - Phone:907-715-8854
Mailing Address - Fax:
Practice Address - Street 1:8752 E VIA DE COMMERCIO STE 1
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3396
Practice Address - Country:US
Practice Address - Phone:480-684-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA16368231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist