Provider Demographics
NPI:1932423167
Name:HALE, JEANNE ELIZABETH (SLP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:ELIZABETH
Last Name:HALE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MONMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-2814
Mailing Address - Country:US
Mailing Address - Phone:479-616-2727
Mailing Address - Fax:
Practice Address - Street 1:2301 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3586
Practice Address - Country:US
Practice Address - Phone:479-631-7678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist