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General NPI Number Information
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NPI Number | 1962423350
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Entity Type | Individual
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Provider Name | ALYCIA MARIE HAAS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 310 CALHOUN AVE STE H
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City | GREENWOOD
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State | SC
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Zip | 29649-2028
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Country | US
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Telephone | 864-388-7529
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Fax | 864-388-7528
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Provider Business Mailing Address
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Address Line | 6827 HIGHWAY 25 S
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City | NINETY SIX
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State | SC
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Zip | 29666-9294
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Country | US
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Telephone | 864-223-5230
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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 | 2912
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License Number State | SC
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