Healthcare Provider Details

I. General information

NPI: 1972010114
Provider Name (Legal Business Name): HALEY VELLANTE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 NORTH AVE # 14
WAKEFIELD MA
01880-1322
US

IV. Provider business mailing address

9 EVANS RD
PEABODY MA
01960-1801
US

V. Phone/Fax

Practice location:
  • Phone: 781-245-4446
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number13231
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: