Doctor Name: | MRS. AUDRA MARIE HALES |
NPI Number: | 1891037180 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 8202 |
Business Practice Address: | 5761 Buckingham Pkwy Culver City, CA - 902306515 |
Business Phone Number: | 3106496199 |
Business Fax Number: | |
Mailing Address: | 1568 Normandy Dr, PASADENA |
State: | CA |
Postal Code: | 911031146 |
Phone Number: | 6192041989 |
Fax Number: | |
NPI Enumeration Date: | 03/25/2013 |
NPI Last Update Date: | 03/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 8202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |