Provider Demographics
NPI:1699294934
Name:HARTY, HAILEY KATHLEEN (MSP, CFY-SLP)
Entity type:Individual
Prefix:MISS
First Name:HAILEY
Middle Name:KATHLEEN
Last Name:HARTY
Suffix:
Gender:F
Credentials:MSP, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:846 MARY KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-3727
Mailing Address - Country:US
Mailing Address - Phone:803-981-4257
Mailing Address - Fax:
Practice Address - Street 1:343 PRADO WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6512
Practice Address - Country:US
Practice Address - Phone:864-270-8647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist