Provider Demographics
NPI:1083483648
Name:HARRELL, HALEY DAWN SUE
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:DAWN SUE
Last Name:HARRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 GLADES RD
Mailing Address - Street 2:
Mailing Address - City:MINFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45653-8679
Mailing Address - Country:US
Mailing Address - Phone:740-716-9916
Mailing Address - Fax:
Practice Address - Street 1:2720 GLADES RD
Practice Address - Street 2:
Practice Address - City:MINFORD
Practice Address - State:OH
Practice Address - Zip Code:45653-8679
Practice Address - Country:US
Practice Address - Phone:740-716-9916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care