Provider Demographics
NPI:1326829607
Name:HENDERSON, HALLE RUSH (MCD-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALLE
Middle Name:RUSH
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MCD-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HARRY RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-9638
Mailing Address - Country:US
Mailing Address - Phone:870-834-2008
Mailing Address - Fax:
Practice Address - Street 1:194 HARRY RD
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-9638
Practice Address - Country:US
Practice Address - Phone:870-834-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist