Provider Demographics
NPI:1205686839
Name:HALE-COX, VIVIAN (SLP)
Entity type:Individual
Prefix:
First Name:VIVIAN
Middle Name:
Last Name:HALE-COX
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:VIVIAN
Other - Middle Name:
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:503 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852-8605
Mailing Address - Country:US
Mailing Address - Phone:662-424-9500
Mailing Address - Fax:662-424-9592
Practice Address - Street 1:503 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-8605
Practice Address - Country:US
Practice Address - Phone:662-424-9500
Practice Address - Fax:662-424-9592
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-5165235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist