Provider Demographics
NPI:1407593999
Name:KNAUS, HALEY ELIZABETH
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:ELIZABETH
Last Name:KNAUS
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 1:19 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8663
Mailing Address - Country:US
Mailing Address - Phone:207-400-0188
Mailing Address - Fax:
Practice Address - Street 1:9 LEWIS RD
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-5410
Practice Address - Country:US
Practice Address - Phone:207-439-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5549225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist