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NPI Code Detail

MEDICARE: HALEY DARR

MEDICARE: HALEY DARR
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
1101YM0800XMental Health Counselor39001755AIN

General Provider Information

NPI Number : 1093228686
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY DARR
Provider Business Mailing Address
First Line : 11401 BLUEGRASS PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-2349
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4410 EXECUTIVE BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46808-1135
Country : US
Telephone Number : 317-452-6279
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2017
Last Update Date : 04/09/2024

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Directions to “ HALEY DARR ” Practice Location

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