Provider Demographics
NPI:1700432226
Name:CARPENTER, HALEY (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:
Other - Last Name:STACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT DPT
Mailing Address - Street 1:703 GRANITE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5350
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:1 COMPASS WAY
Practice Address - Street 2:
Practice Address - City:E BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1465
Practice Address - Country:US
Practice Address - Phone:774-516-2307
Practice Address - Fax:508-205-0130
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist