Provider Demographics
NPI:1568108116
Name:HALL-GAILEY, ANNIE ELLESA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:ELLESA
Last Name:HALL-GAILEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 88TH PL
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-0800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1100 AVENUE K
Practice Address - Street 2:
Practice Address - City:SHALLOWATER
Practice Address - State:TX
Practice Address - Zip Code:79363-5768
Practice Address - Country:US
Practice Address - Phone:806-832-4531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist