Provider Demographics
NPI:1699520601
Name:EIDSE, HAILEY AURIANA (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:AURIANA
Last Name:EIDSE
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 LEE ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1839
Mailing Address - Country:US
Mailing Address - Phone:828-750-4175
Mailing Address - Fax:760-529-4975
Practice Address - Street 1:3355 MISSION AVE STE 123
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92058-1327
Practice Address - Country:US
Practice Address - Phone:760-529-4975
Practice Address - Fax:760-529-4761
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist