Provider Demographics
NPI:1063250470
Name:HALLAN, ELIZA K (MS)
Entity type:Individual
Prefix:MRS
First Name:ELIZA
Middle Name:K
Last Name:HALLAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5112 CAROLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8060
Mailing Address - Country:US
Mailing Address - Phone:919-667-3579
Mailing Address - Fax:
Practice Address - Street 1:5112 CAROLWOOD LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8060
Practice Address - Country:US
Practice Address - Phone:919-667-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist