Provider Demographics
NPI:1982482055
Name:HABER, HAILEY ALEXIS
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:ALEXIS
Last Name:HABER
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 1:39451 US HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-5044
Mailing Address - Country:US
Mailing Address - Phone:605-354-5862
Mailing Address - Fax:
Practice Address - Street 1:39451 US HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-5044
Practice Address - Country:US
Practice Address - Phone:605-354-5862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer