Healthcare Provider Details

I. General information

NPI: 1932097565
Provider Name (Legal Business Name): ALLYSON MARY HAUGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 CAMPUS DR STE 100
COLORADO SPRINGS CO
80920-3107
US

IV. Provider business mailing address

2494 OBSIDIAN FOREST VW
COLORADO SPRINGS CO
80951-9766
US

V. Phone/Fax

Practice location:
  • Phone: 719-597-0822
  • Fax:
Mailing address:
  • Phone: 719-468-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: