Provider Demographics
NPI:1295511673
Name:HANEY, JESSE (MS SLP)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:HANEY
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6214 STATE ROUTE 183 NE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:OH
Mailing Address - Zip Code:44643-8491
Mailing Address - Country:US
Mailing Address - Phone:330-327-8413
Mailing Address - Fax:
Practice Address - Street 1:834 E HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-3052
Practice Address - Country:US
Practice Address - Phone:330-308-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist