Provider Demographics
NPI:1710532254
Name:DWAILEEBE, HALEY L
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:L
Last Name:DWAILEEBE
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 1:1334 E CHANDLER BLVD STE 5-02
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-6267
Mailing Address - Country:US
Mailing Address - Phone:480-518-1535
Mailing Address - Fax:480-718-7633
Practice Address - Street 1:1334 E CHANDLER BLVD STE 5-02
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-6267
Practice Address - Country:US
Practice Address - Phone:480-518-1535
Practice Address - Fax:480-718-7633
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ11773OtherINSURANCE