Provider Demographics
NPI:1629541941
Name:WROTH, HALEY ANN
Entity Type:Individual
Prefix:MISS
First Name:HALEY
Middle Name:ANN
Last Name:WROTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-2437
Mailing Address - Country:US
Mailing Address - Phone:413-244-6846
Mailing Address - Fax:
Practice Address - Street 1:95 FRANK B MURRAY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1106
Practice Address - Country:US
Practice Address - Phone:854-132-8586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program