Provider Demographics
NPI:1285116715
Name:VAN ASCH, HAILEY FLORES (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:FLORES
Last Name:VAN ASCH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:BARTON
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:4827 CEDAR CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-6795
Mailing Address - Country:US
Mailing Address - Phone:804-908-3681
Mailing Address - Fax:
Practice Address - Street 1:2624 W GRACE ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-1944
Practice Address - Country:US
Practice Address - Phone:804-908-3681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-31
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist