Provider Demographics
NPI:1952154932
Name:HANSEN, HALEY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:HATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8757 N JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE MOUNTAIN
Mailing Address - State:UT
Mailing Address - Zip Code:84005-5065
Mailing Address - Country:US
Mailing Address - Phone:402-699-8191
Mailing Address - Fax:
Practice Address - Street 1:331 N 400 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-1999
Practice Address - Country:US
Practice Address - Phone:801-714-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12484262-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist