Provider Demographics
NPI:1659097541
Name:BRADLEY, HALEIGH (AUD)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:
Last Name:BRADLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2654
Mailing Address - Country:US
Mailing Address - Phone:901-316-8851
Mailing Address - Fax:
Practice Address - Street 1:165 N MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2654
Practice Address - Country:US
Practice Address - Phone:901-316-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2012231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist