Individual
HALEY WIDEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
5421 PATTERSON AVE, RICHMOND, VA 23226-2003
(804) 288-0642
(804) 285-0292
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008808
VA
Other
Enumeration date
12/20/2021
Last updated
02/17/2026
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