Provider Demographics
NPI:1295487312
Name:ESSENBURG, HALEY (DPT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:ESSENBURG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:SCHWEIGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67232 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-1915
Mailing Address - Country:US
Mailing Address - Phone:586-430-1154
Mailing Address - Fax:586-430-1174
Practice Address - Street 1:67232 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1915
Practice Address - Country:US
Practice Address - Phone:586-430-1154
Practice Address - Fax:586-430-1154
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501021681225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist