Healthcare Provider Details

I. General information

NPI: 1518381516
Provider Name (Legal Business Name): VIRGINIA HALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 DAYTON ST
HAMILTON OH
45011-3455
US

IV. Provider business mailing address

4663 LAPWING CT
LEBANON OH
45036-2576
US

V. Phone/Fax

Practice location:
  • Phone: 513-887-5000
  • Fax:
Mailing address:
  • Phone: 513-252-8017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number007188
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: