Provider Demographics
NPI:1992286439
Name:HAUGLY, RACHEL (PT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HAUGLY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N8169 SAND HILL DR
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:WI
Mailing Address - Zip Code:53049-1715
Mailing Address - Country:US
Mailing Address - Phone:920-915-1295
Mailing Address - Fax:
Practice Address - Street 1:1506 S ONEIDA ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-1305
Practice Address - Country:US
Practice Address - Phone:920-738-2874
Practice Address - Fax:920-738-2818
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14378-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist