Provider Demographics
NPI:1073184107
Name:RODEHEAVER, HALEY HIXON (AUD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:HIXON
Last Name:RODEHEAVER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:ELIZA
Other - Last Name:HIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:935 NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-729-1635
Mailing Address - Fax:301-729-1697
Practice Address - Street 1:938 NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7326
Practice Address - Country:US
Practice Address - Phone:301-729-1635
Practice Address - Fax:301-729-1697
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01552231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist