Provider Demographics
NPI:1861926701
Name:HAUGHT, CAMILLA (RD)
Entity type:Individual
Prefix:
First Name:CAMILLA
Middle Name:
Last Name:HAUGHT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 OLD ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:BRUCETON MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26525-5313
Mailing Address - Country:US
Mailing Address - Phone:304-288-0136
Mailing Address - Fax:
Practice Address - Street 1:453 VAN VOORHIS RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3408
Practice Address - Country:US
Practice Address - Phone:304-598-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV426133V00000X
WV428133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered