Provider Demographics
NPI:1508408857
Name:VERMILLION, HALEY MICHELLE
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:MICHELLE
Last Name:VERMILLION
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 1:28250 ILESBORO RD
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:OH
Mailing Address - Zip Code:43138-9054
Mailing Address - Country:US
Mailing Address - Phone:740-603-2664
Mailing Address - Fax:
Practice Address - Street 1:2540 BILLINGSLEY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-1990
Practice Address - Country:US
Practice Address - Phone:614-602-6473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator