Provider Demographics
NPI:1578673646
Name:HAUGHTON, JEANETTE E (OTR/CHT)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:E
Last Name:HAUGHTON
Suffix:
Gender:F
Credentials:OTR/CHT
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:E
Other - Last Name:HUIE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/CHT
Mailing Address - Street 1:6109 DONIVAL SQ
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5265
Mailing Address - Country:US
Mailing Address - Phone:703-971-6597
Mailing Address - Fax:
Practice Address - Street 1:6355 WALKER LANE
Practice Address - Street 2:SUITE 512
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310
Practice Address - Country:US
Practice Address - Phone:703-647-3110
Practice Address - Fax:703-822-9955
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02409225X00000X
CA17498225XH1200X
DCOT10000568225XH1200X
VA0119001127225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist