MEDICARE: HALEY JOANNE WATSON

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	30002321	NC

General Provider Information

NPI Number	:	1497533392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY JOANNE WATSON

Provider Business Mailing Address
First Line	:	4909 WATERS EDGE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-2462
Country	:	US
Telephone Number	:	919-285-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	10844 PROVIDENCE RD STE 225
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-4107
Country	:	US
Telephone Number	:	980-288-6822
Fax Number	:

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

Provider Enumeration Date	:	09/20/2023
Last Update Date	:	09/20/2023

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Directions to “ HALEY JOANNE WATSON ” Practice Location

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