Provider Demographics
NPI:1609636125
Name:GLENUM, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:GLENUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 DAVIS GREY DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-0179
Mailing Address - Country:US
Mailing Address - Phone:954-600-5495
Mailing Address - Fax:
Practice Address - Street 1:9 W SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-0047
Practice Address - Country:US
Practice Address - Phone:828-944-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21903235Z00000X
NC30002475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist