Provider Demographics
NPI:1962751719
Name:HALSEY, JUDITH (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HALSEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 KELSEY TRL
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8025
Mailing Address - Country:US
Mailing Address - Phone:513-539-8530
Mailing Address - Fax:
Practice Address - Street 1:15 SOUTHMOOR CIR NE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2451
Practice Address - Country:US
Practice Address - Phone:937-293-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 3185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist