Provider Demographics
NPI:1861450421
Name:HAUGH, MAUREEN PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:HAUGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 E SIMS WAY
Mailing Address - Street 2:NO 322
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-6905
Mailing Address - Country:US
Mailing Address - Phone:360-385-9800
Mailing Address - Fax:360-385-9828
Practice Address - Street 1:260 KALA POINT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-9530
Practice Address - Country:US
Practice Address - Phone:360-385-9800
Practice Address - Fax:360-385-9828
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE323103T00000X
NY015114103T00000X
WAPY00003928103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8872927Medicare PIN
NE274005HAMedicare ID - Type Unspecified