Provider Demographics
NPI:1124867254
Name:SHIRLEY, HALEY (AUD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E DIMOND BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2057
Mailing Address - Country:US
Mailing Address - Phone:907-522-4357
Mailing Address - Fax:
Practice Address - Street 1:1005 E DIMOND BLVD STE 3
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2057
Practice Address - Country:US
Practice Address - Phone:907-522-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK224655231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist