Provider Demographics
NPI:1285105437
Name:LIGHTNER, HALI ANNE (SLP)
Entity type:Individual
Prefix:MRS
First Name:HALI
Middle Name:ANNE
Last Name:LIGHTNER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 S KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3996
Mailing Address - Country:US
Mailing Address - Phone:248-444-7618
Mailing Address - Fax:
Practice Address - Street 1:29270 MORLOCK ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2044
Practice Address - Country:US
Practice Address - Phone:248-476-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005623235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist