Provider Demographics
NPI:1720718604
Name:CHONIN, HALEY OLIVIA
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:OLIVIA
Last Name:CHONIN
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 1:3170 CORAL WAY APT 801
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3351
Mailing Address - Country:US
Mailing Address - Phone:786-390-8847
Mailing Address - Fax:
Practice Address - Street 1:12966 SW 89TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-5850
Practice Address - Country:US
Practice Address - Phone:786-554-8920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA20522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist