Provider Demographics
NPI:1033660253
Name:HANEY, JOSEPH (CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:HANEY
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4203 FAIRACRES RD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2328
Mailing Address - Country:US
Mailing Address - Phone:307-745-3706
Mailing Address - Fax:
Practice Address - Street 1:4203 FAIRACRES RD
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2328
Practice Address - Country:US
Practice Address - Phone:307-745-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist