Healthcare Provider Details

I. General information

NPI: 1891119137
Provider Name (Legal Business Name): STEPHANIE HAYLETT ED.S, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 OAKWOOD AVE
LEBANON OH
45036-1512
US

IV. Provider business mailing address

23 OAKWOOD AVE
LEBANON OH
45036-1512
US

V. Phone/Fax

Practice location:
  • Phone: 513-934-5756
  • Fax:
Mailing address:
  • Phone: 513-934-5756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3021966
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: