Provider Demographics
NPI:1356914220
Name:JOHNSON, HALEY JORDAN (AUD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:JORDAN
Last Name:JOHNSON
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S UNIVERSITY AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5306
Mailing Address - Country:US
Mailing Address - Phone:501-664-5511
Mailing Address - Fax:501-664-5149
Practice Address - Street 1:500 S UNIVERSITY AVE STE 405
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5306
Practice Address - Country:US
Practice Address - Phone:501-664-5511
Practice Address - Fax:501-664-5149
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR200751237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter