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NPI Code Detail

MEDICARE: HADLEY HANEY

MEDICARE: HADLEY HANEY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor16270-131WI
2101YP2500XProfessional Counselor6958-125WI

General Provider Information

NPI Number : 1336693662
Entity Type Code : Individual
Provider Name (Legal Business Name) : HADLEY HANEY
Provider Business Mailing Address
First Line : 502 E NEW YORK AVE
Second Line :
City : OSHKOSH
State : WI
Zip : 54901-3938
Country : US
Telephone Number : 920-234-8893
Fax Number :
Provider Business Practice Location Address
First Line : 502 E NEW YORK AVE
Second Line :
City : OSHKOSH
State : WI
Zip : 54901-3938
Country : US
Telephone Number : 920-234-8893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2016
Last Update Date : 11/22/2024

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Directions to “ HADLEY HANEY ” Practice Location

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