Individual
HALEY CARPENTER BOTELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-2155
Mailing address
238 GREENFIELD RIDGE DR, BRANDON, MS 39042-7020
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3970
MS
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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