Provider Demographics
NPI:1730873738
Name:GRAIR, HALEY ELIZABETH
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ELIZABETH
Last Name:GRAIR
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 1:800 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-2224
Mailing Address - Country:US
Mailing Address - Phone:715-630-1325
Mailing Address - Fax:
Practice Address - Street 1:901 WHALEN RD STE A
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1766
Practice Address - Country:US
Practice Address - Phone:608-476-8485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician