Provider Demographics
NPI:1730380106
Name:HASKELL, HEATHER LOUISE
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LOUISE
Last Name:HASKELL
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:ROZET
Mailing Address - State:WY
Mailing Address - Zip Code:82727-0334
Mailing Address - Country:US
Mailing Address - Phone:307-756-3808
Mailing Address - Fax:307-756-3808
Practice Address - Street 1:261 SHIPWHEEL RD
Practice Address - Street 2:
Practice Address - City:MOORCROFT
Practice Address - State:WY
Practice Address - Zip Code:82721
Practice Address - Country:US
Practice Address - Phone:307-756-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child