Provider Demographics
NPI:1659895019
Name:MACIELEWICZ, HALEY ELYSE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:ELYSE
Last Name:MACIELEWICZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 GENSON DR
Mailing Address - Street 2:
Mailing Address - City:HASKINS
Mailing Address - State:OH
Mailing Address - Zip Code:43525-9522
Mailing Address - Country:US
Mailing Address - Phone:419-344-2419
Mailing Address - Fax:
Practice Address - Street 1:18505 TONTOGANY CREEK RD STE 4
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9037
Practice Address - Country:US
Practice Address - Phone:419-344-2419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.13072235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist