Individual
HALEY PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1034 VICTORIA AVE, FAIRBORN, OH 45324-3768
(937) 986-9792
Mailing address
1034 VICTORIA AVE, FAIRBORN, OH 45324-3768
(937) 986-9792
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
511848
—
OH
Enumeration date
04/27/2020
Last updated
05/20/2020
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