Healthcare Provider Details

I. General information

NPI: 1356802326
Provider Name (Legal Business Name): HALEY CIFANI M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 03/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 SMITH RD
FAIRLAWN OH
44333-2613
US

IV. Provider business mailing address

4469 OXBRIDGE LN
STOW OH
44224-5358
US

V. Phone/Fax

Practice location:
  • Phone: 330-666-1183
  • Fax:
Mailing address:
  • Phone: 740-331-9729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.13047
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: