Provider Demographics
NPI:1457486631
Name:MITCHELL, HAYLEE DAWKINS (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:HAYLEE
Middle Name:DAWKINS
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:HAYLEE
Other - Middle Name:NICOLE
Other - Last Name:DAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 CABIN DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7859
Mailing Address - Country:US
Mailing Address - Phone:803-319-7723
Mailing Address - Fax:
Practice Address - Street 1:325 CABIN DR
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7859
Practice Address - Country:US
Practice Address - Phone:803-319-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3240225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics