Provider Demographics
NPI:1508030776
Name:HAVING, MINDY (PT)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:HAVING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:WENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:132 WOODS EDGE RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65610-7251
Mailing Address - Country:US
Mailing Address - Phone:417-269-7167
Mailing Address - Fax:
Practice Address - Street 1:1097 INDIAN GROVE LN
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-7669
Practice Address - Country:US
Practice Address - Phone:417-766-9819
Practice Address - Fax:417-459-4932
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001020612225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist