Provider Demographics
NPI:1497130348
Name:HALEY, ERIN (MT-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ALDRIN CT
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2925
Mailing Address - Country:US
Mailing Address - Phone:530-228-3483
Mailing Address - Fax:
Practice Address - Street 1:2 ALDRIN CT
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2925
Practice Address - Country:US
Practice Address - Phone:530-228-3483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist