Individual
HALEY THIELEMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5176 WRIGHTSBORO RD, GROVETOWN, GA 30813-2802
(706) 842-3330
(706) 426-1168
Mailing address
5176 WRIGHTSBORO RD, GROVETOWN, GA 30813-2802
(706) 842-3330
(706) 426-1168
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
870-378-6790
PERSONAL PHONE NUMBER
—
Enumeration date
09/16/2019
Last updated
09/16/2019
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