Provider Demographics
NPI:1346556016
Name:HALEY, ANN (SLP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 KIDDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04429-6222
Mailing Address - Country:US
Mailing Address - Phone:207-843-0702
Mailing Address - Fax:
Practice Address - Street 1:202 KIDDER HILL RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:ME
Practice Address - Zip Code:04429-6222
Practice Address - Country:US
Practice Address - Phone:207-843-0702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP736235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist