Healthcare Provider Details

I. General information

NPI: 1851166169
Provider Name (Legal Business Name): HAILEY ANNMARIE HIGHLANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 3RD ST
ROCKLEDGE FL
32955-5703
US

IV. Provider business mailing address

2651 LITTLE BEND PL
MERRITT ISLAND FL
32952-4161
US

V. Phone/Fax

Practice location:
  • Phone: 321-622-8792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT24750
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: