Provider Demographics
NPI:1861484313
Name:HALE, DORIS RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DORIS
Middle Name:RENEE
Last Name:HALE
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 1:2660 AERO DR
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-1528
Mailing Address - Country:US
Mailing Address - Phone:409-729-2227
Mailing Address - Fax:409-729-2001
Practice Address - Street 1:2660 AERO DR
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-1528
Practice Address - Country:US
Practice Address - Phone:409-729-2227
Practice Address - Fax:409-729-2001
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19448235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87806TOtherBLUE CROSS BLUE SHIELD-TX
TX15476OtherUTMB-CHIPS
TX005838001Medicaid
TX0933135OtherCIGNA HEALTHCARE OF TX
TX746012298001OtherHUMANA MILITARY HEALTHCAR
TX0933135OtherCIGNA HEALTHCARE OF TX