Provider Demographics
NPI:1508240177
Name:BANKS, HALEIGH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:
Last Name:BANKS
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 1:14829 ROMULUS RD
Mailing Address - Street 2:
Mailing Address - City:COKER
Mailing Address - State:AL
Mailing Address - Zip Code:35452-3155
Mailing Address - Country:US
Mailing Address - Phone:205-292-3884
Mailing Address - Fax:
Practice Address - Street 1:14829 ROMULUS RD
Practice Address - Street 2:
Practice Address - City:COKER
Practice Address - State:AL
Practice Address - Zip Code:35452-3155
Practice Address - Country:US
Practice Address - Phone:205-292-3884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist