Healthcare Provider Details

I. General information

NPI: 1295491181
Provider Name (Legal Business Name): HALEY COPPER M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY COX M.ED

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 03/08/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

693 LEESVILLE RD
LYNCHBURG VA
24502-2828
US

IV. Provider business mailing address

693 LEESVILLE RD
LYNCHBURG VA
24502-2828
US

V. Phone/Fax

Practice location:
  • Phone: 434-200-5750
  • Fax: 434-237-1737
Mailing address:
  • Phone: 434-200-5750
  • Fax: 434-237-1737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002436
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: