Healthcare Provider Details

I. General information

NPI: 1265001572
Provider Name (Legal Business Name): HAYLEY CHRISTINE JORDAN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 PUTNAM PKWY
OTTAWA OH
45875-8676
US

IV. Provider business mailing address

3159 THORNDYKE DR
LIMA OH
45801-1747
US

V. Phone/Fax

Practice location:
  • Phone: 419-523-5951
  • Fax:
Mailing address:
  • Phone: 419-989-0566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010753
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: