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General NPI Number Information
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NPI Number | 1720718604
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Entity Type | Individual
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Provider Name | HALEY OLIVIA CHONIN
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 12966 SW 89TH AVE
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City | MIAMI
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State | FL
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Zip | 33176-5850
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Country | US
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Telephone | 786-554-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 3170 CORAL WAY APT 801
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City | MIAMI
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State | FL
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Zip | 33145-3351
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Country | US
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Telephone | 786-390-8847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA20522
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License Number State | FL
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