Individual
ANNELISE KATHRYN HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
255 N LINCOLN ST STE A, DIXON, CA 95620-3238
(707) 366-5246
Mailing address
695 CLAREMONT DR, VACAVILLE, CA 95687-5445
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4486
CA
Other
Enumeration date
08/20/2018
Last updated
03/31/2023
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