Provider Demographics
NPI:1437233848
Name:DOEPPERS, HALIANA MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:HALIANA
Middle Name:MARIE
Last Name:DOEPPERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:HALIANA
Other - Middle Name:MARIE
Other - Last Name:HAVEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:340 S WHITNEY WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4656
Mailing Address - Country:US
Mailing Address - Phone:608-238-1312
Mailing Address - Fax:608-238-1464
Practice Address - Street 1:340 S WHITNEY WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-4656
Practice Address - Country:US
Practice Address - Phone:608-238-1312
Practice Address - Fax:608-238-1464
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist