Provider Demographics
NPI:1447980164
Name:HANKE, HALEY
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:HANKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 MALLARD BAY DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:SC
Mailing Address - Zip Code:29745-9779
Mailing Address - Country:US
Mailing Address - Phone:704-616-2617
Mailing Address - Fax:
Practice Address - Street 1:142 TANGLEWOOD CV
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-7783
Practice Address - Country:US
Practice Address - Phone:704-616-2617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health