Provider Demographics
NPI:1396579496
Name:LITTON, HALEY (OTR/L)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:LITTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 WATERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:25213-9551
Mailing Address - Country:US
Mailing Address - Phone:304-550-9988
Mailing Address - Fax:
Practice Address - Street 1:3819 CHESTERFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2647
Practice Address - Country:US
Practice Address - Phone:304-550-9988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7288225X00000X
NC17037225X00000X
WV2119225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist