Provider Demographics
NPI:1508123712
Name:HALES, CATHY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:HALES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 E 580 NORTH CIR
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-1834
Mailing Address - Country:US
Mailing Address - Phone:801-492-1874
Mailing Address - Fax:
Practice Address - Street 1:1154 E 580 NORTH CIR
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-1834
Practice Address - Country:US
Practice Address - Phone:801-492-1874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT330439-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist