Provider Demographics
NPI:1326881814
Name:PINKERMAN, HALEY EMILY (COTA/L)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:EMILY
Last Name:PINKERMAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:EMILY
Other - Last Name:MICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2331 E REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-8994
Mailing Address - Country:US
Mailing Address - Phone:865-585-0384
Mailing Address - Fax:
Practice Address - Street 1:9317 VIENNA RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:MI
Practice Address - Zip Code:48457-9729
Practice Address - Country:US
Practice Address - Phone:810-639-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202010190224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant