Provider Demographics
NPI:1538942255
Name:HERNANDEZ, HALEY RAE
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:RAE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1368 E SHANNON ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-4952
Mailing Address - Country:US
Mailing Address - Phone:480-620-0828
Mailing Address - Fax:
Practice Address - Street 1:1945 S ASHLAND RANCH RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-4993
Practice Address - Country:US
Practice Address - Phone:480-917-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist