Provider Demographics
NPI:1841315769
Name:HALONEN, MARY PATRICIA (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:PATRICIA
Last Name:HALONEN
Suffix:
Gender:F
Credentials:PT
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Other - First Name:
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Mailing Address - Street 1:26432 EL MAR DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6102
Mailing Address - Country:US
Mailing Address - Phone:949-582-5175
Mailing Address - Fax:949-582-5960
Practice Address - Street 1:23293 SOUTH POINTE DRIVE
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-770-5843
Practice Address - Fax:949-770-9546
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT2648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist