MEDICARE: HAILEY ZEHNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	5714	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5714	OTHER	SC	LLR

General Provider Information

NPI Number	:	1093194847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILEY ZEHNER

Provider Business Mailing Address
First Line	:	202 BRITON WAY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-4329
Country	:	US
Telephone Number	:	503-577-4598
Fax Number	:

Provider Business Practice Location Address
First Line	:	1547 WADE HAMPTON BLVD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29609-5047
Country	:	US
Telephone Number	:	864-659-0578
Fax Number	:	864-568-7255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2015
Last Update Date	:	07/14/2022

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Directions to “ HAILEY ZEHNER ” Practice Location

Language	Start Address	Practice Location

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