Provider Demographics
NPI:1376122374
Name:MCCLURG, HAYLEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HAYLEE
Middle Name:
Last Name:MCCLURG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-7922
Mailing Address - Country:US
Mailing Address - Phone:606-541-6581
Mailing Address - Fax:
Practice Address - Street 1:1112 GALLIA ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4161
Practice Address - Country:US
Practice Address - Phone:740-981-3176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011495225X00000X
KY269896225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist