MEDICARE: HAYLEY MOLEN

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1659062180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY MOLEN

Provider Business Mailing Address
First Line	:	1138 TEAKWOOD DR
Second Line	:
City	:	SOUTH CHARLESTON
State	:	OH
Zip	:	45368-9719
Country	:	US
Telephone Number	:	937-346-4522
Fax Number	:

Provider Business Practice Location Address
First Line	:	1138 TEAKWOOD DR
Second Line	:
City	:	SOUTH CHARLESTON
State	:	OH
Zip	:	45368-9719
Country	:	US
Telephone Number	:	937-346-4522
Fax Number	:

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

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

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Directions to “ HAYLEY MOLEN ” Practice Location

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