Provider Demographics
NPI:1932724432
Name:DIENST, HAILEY PAIGE (LMT)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:PAIGE
Last Name:DIENST
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 COTTSWOLD DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2812
Mailing Address - Country:US
Mailing Address - Phone:740-815-9684
Mailing Address - Fax:
Practice Address - Street 1:805 HILLSDOWNE RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7308
Practice Address - Country:US
Practice Address - Phone:614-794-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.020986225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty