Provider Demographics
NPI:1164943247
Name:BUCHNER, HAILEY KRISTINE-MAYO (MS, CFY-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:KRISTINE-MAYO
Last Name:BUCHNER
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 WILFRED ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-4533
Mailing Address - Country:US
Mailing Address - Phone:231-571-0727
Mailing Address - Fax:
Practice Address - Street 1:300 S RATH AVE STE 102
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2085
Practice Address - Country:US
Practice Address - Phone:231-571-0727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist