Provider Demographics
NPI:1902454424
Name:HEAD, HALEY DANIELLE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:DANIELLE
Last Name:HEAD
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:DANIELLE
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1062 SUMMIT DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3864
Mailing Address - Country:US
Mailing Address - Phone:205-413-7840
Mailing Address - Fax:
Practice Address - Street 1:1132 RUTHERFORD RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3927
Practice Address - Country:US
Practice Address - Phone:864-250-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist