Provider Demographics
NPI:1477045847
Name:HICKEY, HAILY ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:HAILY
Middle Name:ELIZABETH
Last Name:HICKEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HAILY
Other - Middle Name:ELIZABETH
Other - Last Name:VANDEPOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12531 W STATE HIGHWAY 71 APT 2312
Mailing Address - Street 2:
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6649
Mailing Address - Country:US
Mailing Address - Phone:616-405-5181
Mailing Address - Fax:
Practice Address - Street 1:15820 ADDISON RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3549
Practice Address - Country:US
Practice Address - Phone:214-575-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist