MEDICARE: HAYLEE CROSLOW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1053266429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEE CROSLOW

Provider Business Mailing Address
First Line	:	215 BRYLAND WAY
Second Line	:
City	:	FOUNTAIN INN
State	:	SC
Zip	:	29644-1967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 BRYLAND WAY
Second Line	:
City	:	FOUNTAIN INN
State	:	SC
Zip	:	29644-1967
Country	:	US
Telephone Number	:	765-259-2111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ HAYLEE CROSLOW ” Practice Location

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