Provider Demographics
NPI:1386774792
Name:HAUGHIE, LAURA JEAN (DPT, PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JEAN
Last Name:HAUGHIE
Suffix:
Gender:F
Credentials:DPT, PHD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:JEAN
Other - Last Name:HAUGHIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT, PHD
Mailing Address - Street 1:450 SW 11TH PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7163
Mailing Address - Country:US
Mailing Address - Phone:561-417-6266
Mailing Address - Fax:
Practice Address - Street 1:1500 E HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4355
Practice Address - Country:US
Practice Address - Phone:954-429-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4291225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY 2335Medicare ID - Type Unspecified