Provider Demographics
NPI:1427501246
Name:HULST, HALEY L (OTR/L)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:L
Last Name:HULST
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:L
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:339 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2593
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1300 BEARD ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6562
Practice Address - Country:US
Practice Address - Phone:810-982-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009081225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist