Provider Demographics
NPI:1558842591
Name:WAKEFIELD, HAILEY VAUGHAN HUNDLEY (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:VAUGHAN HUNDLEY
Last Name:WAKEFIELD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:VAUGHAN
Other - Last Name:HUNDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:723 SILVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2460 MARSH LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-1612
Practice Address - Country:US
Practice Address - Phone:214-731-5955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist