Provider Demographics
NPI:1417781410
Name:WALTMAN, HALEY CHRISINE
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:CHRISINE
Last Name:WALTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 REAGAN ST APT 105
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3482
Mailing Address - Country:US
Mailing Address - Phone:979-220-1300
Mailing Address - Fax:
Practice Address - Street 1:32018 HWY 59
Practice Address - Street 2:
Practice Address - City:MAUD
Practice Address - State:OK
Practice Address - Zip Code:74854-0008
Practice Address - Country:US
Practice Address - Phone:979-220-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist