Provider Demographics
NPI:1437698693
Name:LAUGS, HEATHER R
Entity Type:Individual
Prefix:MISS
First Name:HEATHER
Middle Name:R
Last Name:LAUGS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:R
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 STONY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12835-2244
Mailing Address - Country:US
Mailing Address - Phone:518-696-6140
Mailing Address - Fax:
Practice Address - Street 1:27 STONY CREEK RD
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:NY
Practice Address - Zip Code:12835-2244
Practice Address - Country:US
Practice Address - Phone:518-696-6140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1687460174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist