Provider Demographics
NPI:1992449375
Name:FERGUSON, HALEY (MA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17195 SW 49TH PL
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4919
Mailing Address - Country:US
Mailing Address - Phone:786-506-4362
Mailing Address - Fax:
Practice Address - Street 1:150 S PINE ISLAND RD STE 300
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2665
Practice Address - Country:US
Practice Address - Phone:954-860-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty