Provider Demographics
NPI:1891368767
Name:CONNOLLY, HALEY JANET (AUD)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:JANET
Last Name:CONNOLLY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 SE 39TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-5083
Mailing Address - Country:US
Mailing Address - Phone:570-932-0171
Mailing Address - Fax:
Practice Address - Street 1:3350 WOODS EDGE CIR
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-1366
Practice Address - Country:US
Practice Address - Phone:239-948-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2505231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist