Provider Demographics
NPI:1740026954
Name:FUNKHOUSER, HALEY BROOKE
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:BROOKE
Last Name:FUNKHOUSER
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 1:1525 RECTOR LN
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1968
Mailing Address - Country:US
Mailing Address - Phone:502-541-0550
Mailing Address - Fax:
Practice Address - Street 1:1002 SISTER BARBARA WAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-8781
Practice Address - Country:US
Practice Address - Phone:812-940-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist