Provider Demographics
NPI:1417503640
Name:HAUGEN, HANNAH (DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HAUGEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5445 WESTMORLAND DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-4812
Mailing Address - Country:US
Mailing Address - Phone:406-871-2835
Mailing Address - Fax:
Practice Address - Street 1:2411 W MAIN ST # 2A
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3815
Practice Address - Country:US
Practice Address - Phone:406-219-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-270072251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics