Healthcare Provider Details

I. General information

NPI: 1154552719
Provider Name (Legal Business Name): STACEY L HAUGHT PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY BRUBAKER PT

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 N FRANKLIN DR STE 4-5
WASHINGTON PA
15301-5874
US

IV. Provider business mailing address

2112 N FRANKLIN DR STE 4-5
WASHINGTON PA
15301-5874
US

V. Phone/Fax

Practice location:
  • Phone: 724-705-7050
  • Fax:
Mailing address:
  • Phone: 724-705-7050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305206037
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019898
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: