Provider Demographics
NPI:1598310666
Name:HARMON, HAYLEE MYA-CAROL
Entity Type:Individual
Prefix:
First Name:HAYLEE
Middle Name:MYA-CAROL
Last Name:HARMON
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 1:56 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01464-2604
Mailing Address - Country:US
Mailing Address - Phone:508-353-7896
Mailing Address - Fax:
Practice Address - Street 1:207 AUTHORITY DR
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6044
Practice Address - Country:US
Practice Address - Phone:978-696-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist