MEDICARE: COLETTE M HALEY LMT

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	171100000X	Acupuncturist	65.000217	OH
2	225700000X	Massage Therapist	33.015717	OH

General Provider Information

NPI Number	:	1740614544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLETTE M HALEY LMT

Provider Business Mailing Address
First Line	:	193 E WHITTIER ST
Second Line	:	RM 6
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2638
Country	:	US
Telephone Number	:	614-654-0654
Fax Number	:

Provider Business Practice Location Address
First Line	:	193 E WHITTIER ST
Second Line	:	RM 6
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2638
Country	:	US
Telephone Number	:	614-654-0654
Fax Number	:

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

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	08/28/2013

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Directions to “ COLETTE M HALEY LMT” Practice Location

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