Healthcare Provider Details

I. General information

NPI: 1477932010
Provider Name (Legal Business Name): CORINNE HALE M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1858 N ALAFAYA TRL STE 207
ORLANDO FL
32826-4754
US

IV. Provider business mailing address

720 S CHICKASAW TRL
ORLANDO FL
32825-7808
US

V. Phone/Fax

Practice location:
  • Phone: 407-900-5313
  • Fax:
Mailing address:
  • Phone: 321-806-0474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: