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NPI Code Detail

MEDICARE: HAILEY FITZGERALD

MEDICARE: HAILEY FITZGERALD
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 Counselor

General Provider Information

NPI Number : 1457928889
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEY FITZGERALD
Provider Business Mailing Address
First Line : 5 COPPER HILL CT
Second Line :
City : DURHAM
State : NC
Zip : 27713-9447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 614 HOWARD ST
Second Line :
City : BOONE
State : NC
Zip : 28608-0020
Country : US
Telephone Number : 828-262-3180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2021
Last Update Date : 06/04/2021

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Directions to “ HAILEY FITZGERALD ” Practice Location

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