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General NPI Number Information
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NPI Number | 1326568478
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Entity Type | Individual
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Provider Name | HAYLEE POTTEIGER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 13030 WARWICK BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-8374
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Country | US
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Telephone | 757-249-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 800 LOMBARDY AVE APT 8405
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-3380
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Country | US
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Telephone | 717-364-2110
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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 | 0119007341
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License Number State | VA
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