Healthcare Provider Details

I. General information

NPI: 1205436672
Provider Name (Legal Business Name): MRS. LYDIA K HAUGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 PENNSYLVANIA AVE
IRWIN PA
15642-3737
US

IV. Provider business mailing address

1015 PENNSYLVANIA AVE
IRWIN PA
15642-3737
US

V. Phone/Fax

Practice location:
  • Phone: 866-287-2036
  • Fax:
Mailing address:
  • Phone: 866-287-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number20-45971
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: