Healthcare Provider Details

I. General information

NPI: 1619573441
Provider Name (Legal Business Name): MISS HALEY MCKENNA CURL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 1ST ST
JACKSON MI
49201-2102
US

IV. Provider business mailing address

207 1ST ST
JACKSON MI
49201-2102
US

V. Phone/Fax

Practice location:
  • Phone: 517-998-4673
  • Fax:
Mailing address:
  • Phone: 517-998-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: