Provider Demographics
NPI:1003632167
Name:ARCHER, HALEY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ARCHER
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 1:21696 HICKORY HILL LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-4231
Mailing Address - Country:US
Mailing Address - Phone:256-443-6175
Mailing Address - Fax:
Practice Address - Street 1:21696 HICKORY HILL LN
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-4231
Practice Address - Country:US
Practice Address - Phone:256-443-6175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4486174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist