Healthcare Provider Details

I. General information

NPI: 1669686630
Provider Name (Legal Business Name): THE HALLWAY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12881 KNOTT ST STE 103
GARDEN GROVE CA
92841-3939
US

IV. Provider business mailing address

12881 KNOTT ST STE 103
GARDEN GROVE CA
92841-3939
US

V. Phone/Fax

Practice location:
  • Phone: 714-892-6828
  • Fax: 714-898-9720
Mailing address:
  • Phone: 714-892-6828
  • Fax: 714-898-9720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberOT3850
License Number StateCA

VIII. Authorized Official

Name: MS. MARY KATHERINE HALLWAY
Title or Position: PRESIDENT
Credential: OTR
Phone: 714-892-6828