MEDICARE: HAYLEY RABBIT

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	225X00000X	Occupational Therapist	OT20019	FL
2	225X00000X	Occupational Therapist	5001	AL

General Provider Information

NPI Number	:	1922661255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY RABBIT

Provider Business Mailing Address
First Line	:	251 JOHNSTON ST SE STE 200
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-350-1764
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 JOHNSTON ST SE STE 200
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-2515
Country	:	US
Telephone Number	:	256-350-1764
Fax Number	:

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

Provider Enumeration Date	:	04/22/2019
Last Update Date	:	03/04/2021

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Directions to “ HAYLEY RABBIT ” Practice Location

Language	Start Address	Practice Location

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