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NPI Code Detail

MEDICARE: HALEY ALLEN

MEDICARE: HALEY ALLEN
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
1225X00000XOccupational TherapistOT007354GA
2225X00000XOccupational Therapist7029TN
3225X00000XOccupational Therapist4660NM

General Provider Information

NPI Number : 1669033056
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ALLEN
Provider Business Mailing Address
First Line : 1225 BROADRICK DR
Second Line :
City : DALTON
State : GA
Zip : 30720-2504
Country : US
Telephone Number : 706-272-6199
Fax Number : 706-281-5618
Provider Business Practice Location Address
First Line : 405 HUNTER ST
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-2656
Country : US
Telephone Number : 618-447-2422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2019
Last Update Date : 01/27/2023

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Directions to “ HALEY ALLEN ” Practice Location

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