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General NPI Number Information
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NPI Number | 1295650455
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Entity Type | Individual
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Provider Name | ALYSSA MARIE HAUCK LSW
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Gender | Female
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Dates
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Enumeration Date | 08/13/2026
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Last Update Date | 08/13/2026
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Provider Practice Location Address
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Address Line | 1 W MAIN ST
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City | FLEETWOOD
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State | PA
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Zip | 19522-1350
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Country | US
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Telephone | 610-944-0445
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Fax |
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Provider Business Mailing Address
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Address Line | 191 CLUB RD
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City | OLEY
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State | PA
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Zip | 19547-8410
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Country | US
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Telephone | 610-468-2445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW136997
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License Number State | PA
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