Provider Demographics
NPI:1811459951
Name:HAZLETT, LAYLA (OTR/L)
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:HAZLETT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COBB RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:NY
Mailing Address - Zip Code:13411-4514
Mailing Address - Country:US
Mailing Address - Phone:845-800-2099
Mailing Address - Fax:
Practice Address - Street 1:105 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-6175
Practice Address - Country:US
Practice Address - Phone:607-353-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024425225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist