Provider Demographics
NPI:1639796626
Name:MOORMAN, HALEY MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARIE
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:MARIE
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:PO BOX 801143
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1143
Mailing Address - Country:US
Mailing Address - Phone:573-331-5583
Mailing Address - Fax:573-331-5079
Practice Address - Street 1:150 S MOUNT AUBURN RD STE 420
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4911
Practice Address - Country:US
Practice Address - Phone:573-335-4448
Practice Address - Fax:573-335-4466
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020018533231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist