Provider Demographics
NPI:1306581707
Name:HUSETH, HAILEY G
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:G
Last Name:HUSETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 SOGN VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:DENNISON
Mailing Address - State:MN
Mailing Address - Zip Code:55018-7749
Mailing Address - Country:US
Mailing Address - Phone:507-301-4767
Mailing Address - Fax:
Practice Address - Street 1:24 8TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6817
Practice Address - Country:US
Practice Address - Phone:507-289-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist