Provider Demographics
NPI:1265715536
Name:REEVES, HALEY (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13211 LANSDOWN ST
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-0078
Mailing Address - Country:US
Mailing Address - Phone:870-222-8273
Mailing Address - Fax:
Practice Address - Street 1:1900 N DOWNING RD
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3706
Practice Address - Country:US
Practice Address - Phone:979-997-7139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR14049854235Z00000X
TX235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR186228721Medicaid