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General NPI Number Information
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NPI Number | 1518664267
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Entity Type | Individual
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Provider Name | REBECCA JANE HINES HAUDER
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 2255 JOHN F KENNEDY RD
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City | DUBUQUE
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State | IA
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Zip | 52002-2846
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Country | US
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Telephone | 563-583-3629
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Fax |
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Provider Business Mailing Address
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Address Line | 1878 HUMMINGBIRD DR
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City | DUBUQUE
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State | IA
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Zip | 52002-2222
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Country | US
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Telephone | 563-580-3767
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 6137
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License Number State | IA
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