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General NPI Number Information
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NPI Number | 1427608181
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Entity Type | Individual
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Provider Name | HALEY THIELEMIER
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Gender | Female
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 5176 WRIGHTSBORO RD
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City | GROVETOWN
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State | GA
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Zip | 30813-2802
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Country | US
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Telephone | 706-842-3330
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Fax | 706-426-1168
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Provider Business Mailing Address
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Address Line | 5176 WRIGHTSBORO RD
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City | GROVETOWN
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State | GA
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Zip | 30813-2802
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Country | US
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Telephone | 706-842-3330
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Fax | 706-426-1168
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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