Provider Demographics
NPI:1477353480
Name:MYER, HAILEY ELIZABETH KAY
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:ELIZABETH KAY
Last Name:MYER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:ELIZABETH KAY
Other - Last Name:BRUNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1750 CLEMENTS LN
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-5352
Mailing Address - Country:US
Mailing Address - Phone:509-531-2208
Mailing Address - Fax:
Practice Address - Street 1:1820 E 17TH ST STE 330
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6400
Practice Address - Country:US
Practice Address - Phone:208-497-0685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker