Healthcare Provider Details

I. General information

NPI: 1083507545
Provider Name (Legal Business Name): HALEY LAYCOCK AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 GLEN ESTE WITHAMSVILLE RD STE 475
CINCINNATI OH
45245-1340
US

IV. Provider business mailing address

2825 BURNET AVE STE 330
CINCINNATI OH
45219-2426
US

V. Phone/Fax

Practice location:
  • Phone: 513-947-8470
  • Fax: 513-947-8428
Mailing address:
  • Phone: 513-221-0527
  • Fax: 513-221-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.02602
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: