Provider Demographics
NPI:1154090652
Name:GINGRICH, HALEY
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:GINGRICH
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 1:325 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1104
Mailing Address - Country:US
Mailing Address - Phone:844-588-4222
Mailing Address - Fax:717-775-3443
Practice Address - Street 1:325 N 2ND ST
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1104
Practice Address - Country:US
Practice Address - Phone:844-588-4222
Practice Address - Fax:717-775-3443
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician