Provider Demographics
NPI:1205678836
Name:FORD, HALEY GAIL
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:GAIL
Last Name:FORD
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 1:3430 LONE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CALVERT CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42029-8320
Mailing Address - Country:US
Mailing Address - Phone:270-205-2268
Mailing Address - Fax:
Practice Address - Street 1:3235 OLIVET CHURCH RD STE D
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9545
Practice Address - Country:US
Practice Address - Phone:270-443-5712
Practice Address - Fax:270-933-1095
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist