Provider Demographics
NPI:1124115670
Name:HAUG, RODNEY J (PHD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:J
Last Name:HAUG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 ELBA CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3566
Mailing Address - Country:US
Mailing Address - Phone:307-214-2888
Mailing Address - Fax:
Practice Address - Street 1:2321 DUNN AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3214
Practice Address - Country:US
Practice Address - Phone:307-214-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY383103TC0700X
ND149103TC0700X
CO2661103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical