Provider Demographics
NPI:1841987500
Name:HAASCH, CARRIE HUMPHRIES (RDH)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:HUMPHRIES
Last Name:HAASCH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5248 MISTY SPRING DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3186
Mailing Address - Country:US
Mailing Address - Phone:804-514-6729
Mailing Address - Fax:
Practice Address - Street 1:1612 HUGUENOT RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2427
Practice Address - Country:US
Practice Address - Phone:804-794-9789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402204240124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist