Provider Demographics
NPI:1699576132
Name:GROVE, HAYLEY MARIE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MARIE
Last Name:GROVE
Suffix:
Gender:
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:MARIE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10995 ALLISONVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2617
Mailing Address - Country:US
Mailing Address - Phone:317-956-1082
Mailing Address - Fax:
Practice Address - Street 1:10995 ALLISONVILLE RD STE 101
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2617
Practice Address - Country:US
Practice Address - Phone:317-956-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007435A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist