Provider Demographics
NPI:1508508946
Name:VERRILLO, HALEY (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:VERRILLO
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 1:3 EVES DR STE 308
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3129
Mailing Address - Country:US
Mailing Address - Phone:856-334-5238
Mailing Address - Fax:
Practice Address - Street 1:3 EVES DR STE 308
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3129
Practice Address - Country:US
Practice Address - Phone:856-334-5238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01133900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist