Provider Demographics
NPI:1932495967
Name:ALFRED, HAILEY LAMARR (DPT)
Entity Type:Individual
Prefix:MRS
First Name:HAILEY
Middle Name:LAMARR
Last Name:ALFRED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 N SCOTTSDALE RD STE 301
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4060
Mailing Address - Country:US
Mailing Address - Phone:805-458-1041
Mailing Address - Fax:
Practice Address - Street 1:13430 N SCOTTSDALE RD STE 301
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4060
Practice Address - Country:US
Practice Address - Phone:805-458-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist