Individual
STACEY L HAUGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4016 RAINTREE RD, SUITE 240, CHESAPEAKE, VA 23321-3700
(757) 488-2864
(757) 488-4735
Mailing address
4016 RAINTREE RD, SUITE 240, CHESAPEAKE, VA 23321-3700
(757) 488-2864
(757) 488-4735
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305206037
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004979061
—
VA
Enumeration date
07/30/2009
Last updated
07/30/2009
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