Provider Demographics
NPI:1609081207
Name:HAGGERTY, VERONICA S (RN)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:S
Last Name:HAGGERTY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:PA
Mailing Address - Zip Code:18938-2234
Mailing Address - Country:US
Mailing Address - Phone:215-803-8816
Mailing Address - Fax:215-862-7288
Practice Address - Street 1:126 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-2234
Practice Address - Country:US
Practice Address - Phone:215-803-8816
Practice Address - Fax:215-862-7288
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN326370L101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional