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NPI Code Detail

MEDICARE: HEATHER RENEE HAAS M.S., LMFT

MEDICARE:   HEATHER RENEE HAAS  M.S., LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist743-124WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326171604
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER RENEE HAAS M.S., LMFT
Provider Business Mailing Address
First Line : 613 WASHINGTON ST
Second Line :
City : SAUK CITY
State : WI
Zip : 53583-1445
Country : US
Telephone Number : 608-698-1145
Fax Number :
Provider Business Practice Location Address
First Line : S2845 WHITE EAGLE RD
Second Line :
City : BARABOO
State : WI
Zip : 53913-9064
Country : US
Telephone Number : 608-355-1240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/09/2007

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