Provider Demographics
NPI:1356862825
Name:DORAN, HALEY MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARIE
Last Name:DORAN
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 1:3001 NE HUNTINGTON LN
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4623
Mailing Address - Country:US
Mailing Address - Phone:515-402-7717
Mailing Address - Fax:
Practice Address - Street 1:2455 SW STATE ST STE 105
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1277
Practice Address - Country:US
Practice Address - Phone:515-963-4528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108468235Z00000X
COPSLP.0000232235Z00000X
CO0003398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist