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General NPI Number Information
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NPI Number | 1619705399
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Entity Type | Individual
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Provider Name | HALEY DENISE MEYER
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Gender | Female
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1772 STIEGER LAKE LN
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City | VICTORIA
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State | MN
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Zip | 55386-7720
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Country | US
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Telephone | 952-443-9888
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 PONDVIEW AVE NW
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City | MONTGOMERY
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State | MN
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Zip | 56069-4484
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Country | US
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Telephone | 952-688-2852
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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 |
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License Number State |
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Taxonomy #2
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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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