Provider Demographics
NPI:1588400196
Name:HALLIBURTON, AUBREY
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:HALLIBURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 AMBIE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-5006
Mailing Address - Country:US
Mailing Address - Phone:615-636-3935
Mailing Address - Fax:
Practice Address - Street 1:3011 LONGFORD DR STE 4
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-6203
Practice Address - Country:US
Practice Address - Phone:615-241-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty