Provider Demographics
NPI:1699402503
Name:WILKENING, HAYLEE M (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:HAYLEE
Middle Name:M
Last Name:WILKENING
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:DR
Other - First Name:HAYLEE
Other - Middle Name:M
Other - Last Name:WILKENING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:240 BEL AIRE DR
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-9772
Mailing Address - Country:US
Mailing Address - Phone:641-750-1261
Mailing Address - Fax:
Practice Address - Street 1:8810 SWANSON BLVD
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-6910
Practice Address - Country:US
Practice Address - Phone:641-750-1261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist