Healthcare Provider Details

I. General information

NPI: 1134760523
Provider Name (Legal Business Name): ASHLEY HAUGLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 6TH ST S
HUMBOLDT IA
50548-2028
US

IV. Provider business mailing address

PO BOX 135
THOR IA
50591-0135
US

V. Phone/Fax

Practice location:
  • Phone: 515-851-8279
  • Fax:
Mailing address:
  • Phone: 515-851-8279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: