Provider Demographics
NPI:1013791607
Name:KRESS, HALEY MIRANDA
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:MIRANDA
Last Name:KRESS
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 1:2224 E MAIN ST APT 1027
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-4906
Mailing Address - Country:US
Mailing Address - Phone:361-219-0280
Mailing Address - Fax:
Practice Address - Street 1:1 COYOTE TRL
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801
Practice Address - Country:US
Practice Address - Phone:830-591-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT97562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer