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General NPI Number Information
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NPI Number | 1275313405
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Entity Type | Individual
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Provider Name | HALEY GRANT OTR
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Gender | Female
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 2637 IRA E WOODS AVE STE 1020
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City | GRAPEVINE
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State | TX
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Zip | 76051-9010
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Country | US
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Telephone | 817-865-5447
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Fax | 817-704-2598
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Provider Business Mailing Address
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Address Line | 15333 HENRIETTA BEND DR
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City | ROANOKE
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State | TX
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Zip | 76262-6594
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Country | US
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Telephone |
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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 | 121915
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License Number State | TX
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