Healthcare Provider Details

I. General information

NPI: 1639585748
Provider Name (Legal Business Name): MS. HALEIGH MAE MEYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 07/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 CECIL AVE S
MILLERSVILLE MD
21108-2111
US

IV. Provider business mailing address

899 CECIL AVE S
MILLERSVILLE MD
21108-2111
US

V. Phone/Fax

Practice location:
  • Phone: 410-923-2020
  • Fax:
Mailing address:
  • Phone: 410-923-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberA02133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: