Provider Demographics
NPI:1609188861
Name:RIEMENSCHNEIDER, HALEY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:
Last Name:RIEMENSCHNEIDER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 RICHARDS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2653
Mailing Address - Country:US
Mailing Address - Phone:501-955-2220
Mailing Address - Fax:501-955-5531
Practice Address - Street 1:119 W H AVE
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-8733
Practice Address - Country:US
Practice Address - Phone:501-772-3224
Practice Address - Fax:501-771-7648
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-04
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10-0072355S0801X
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR186630721Medicaid