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General NPI Number Information
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NPI Number | 1669033056
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Entity Type | Individual
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Provider Name | HALEY ALLEN
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 405 HUNTER ST
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City | ESPANOLA
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State | NM
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Zip | 87532-2656
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Country | US
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Telephone | 618-447-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-2504
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Country | US
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Telephone | 706-272-6199
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Fax | 706-281-5618
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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 | OT007354
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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 | 7029
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4660
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License Number State | NM
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