Provider Demographics
NPI:1881352920
Name:HAUGEN, SARAH M
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:HAUGEN
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 1:122 DEER PATH CT
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-6004
Mailing Address - Country:US
Mailing Address - Phone:614-288-4678
Mailing Address - Fax:
Practice Address - Street 1:122 DEER PATH CT
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-6004
Practice Address - Country:US
Practice Address - Phone:614-288-4678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No174200000XOther Service ProvidersMeals