Provider Demographics
NPI:1992310775
Name:WATSON, HAYLEE TONI MARIE
Entity type:Individual
Prefix:
First Name:HAYLEE
Middle Name:TONI MARIE
Last Name:WATSON
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 1:324 DOLLAR LN
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25413
Mailing Address - Country:US
Mailing Address - Phone:304-886-5191
Mailing Address - Fax:
Practice Address - Street 1:324 DOLLAR LN
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:WV
Practice Address - Zip Code:25413
Practice Address - Country:US
Practice Address - Phone:304-886-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant