Individual
DR. GUSTAVO R. HALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
8601 SIX FORKS RD STE 400, RALEIGH, NC 27615-5276
(919) 356-1739
Mailing address
2124 LONGMONT DR, WAKE FOREST, NC 27587-5910
(787) 362-5479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
02002
PR
103TC0700X
Clinical Psychologist
PS1194
ME
103TH0100X
Health Service Psychologist
Primary
6320
NC
Other
Enumeration date
11/20/2006
Last updated
07/14/2023
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