Provider Demographics
NPI:1104491018
Name:HUGG, HAYLEY (PT,DPT)
Entity type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:
Last Name:HUGG
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:3515 16TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701
Mailing Address - Country:US
Mailing Address - Phone:701-838-1080
Mailing Address - Fax:701-838-1630
Practice Address - Street 1:3515 16TH ST SW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-838-1080
Practice Address - Fax:701-838-1630
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2472225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1482606Medicaid