Provider Demographics
NPI:1912618349
Name:DONOWAY, HALEY MARIE (RD)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MARIE
Last Name:DONOWAY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1389 W CENTERTON BLVD APT 724
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-8738
Mailing Address - Country:US
Mailing Address - Phone:501-428-5269
Mailing Address - Fax:
Practice Address - Street 1:111 SE 22ND ST STE 11
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-5180
Practice Address - Country:US
Practice Address - Phone:479-346-2143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2321133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered