Provider Demographics
NPI:1932956034
Name:HAYDUKE, ALLISON (SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HAYDUKE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:HAYDUKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6020 WARDEN RD STE 230
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-6015
Mailing Address - Country:US
Mailing Address - Phone:501-392-9180
Mailing Address - Fax:501-392-9184
Practice Address - Street 1:6020 WARDEN RD STE 230
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-6015
Practice Address - Country:US
Practice Address - Phone:501-392-9180
Practice Address - Fax:501-392-9184
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202552235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist