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Individual
HALEY C MAXWELL
Active
Individual
HALEY C MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PA9113981
FL
363A00000X
Physician Assistant
Primary
PA9113981
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9113981
PA LICENCE
FL
Enumeration date
01/21/2021
Last updated
05/20/2022
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