Healthcare Provider Details

I. General information

NPI: 1164341277
Provider Name (Legal Business Name): HALEY GREENWAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7390 NW 5TH ST STE 1
PLANTATION FL
33317-1610
US

IV. Provider business mailing address

7390 NW 5TH ST STE 1
PLANTATION FL
33317-1610
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-7383
  • Fax:
Mailing address:
  • Phone: 954-583-7383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13379
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: