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General NPI Number Information
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NPI Number | 1265276893
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Entity Type | Individual
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Provider Name | HALEY LONG
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Gender | Female
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Dates
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Enumeration Date | 06/19/2024
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 901 CLARK ST
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City | OVIEDO
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State | FL
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Zip | 32765-7378
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Country | US
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Telephone | 407-359-5693
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Fax | 407-792-5693
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Provider Business Mailing Address
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Address Line | 473 SUN LAKE CIR APT 101
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City | LAKE MARY
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State | FL
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Zip | 32746-2465
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Country | US
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Telephone | 478-832-1295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT009186
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 25879
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License Number State | FL
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