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NPI Code Detail

MEDICARE: EMMA RAE HAASE

MEDICARE: EMMA RAE HAASE
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1710779822
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA RAE HAASE
Provider Business Mailing Address
First Line : 975 CHARNELTON ST UNIT 601
Second Line :
City : EUGENE
State : OR
Zip : 97401-3087
Country : US
Telephone Number : 319-559-0602
Fax Number :
Provider Business Practice Location Address
First Line : 3539 DOUGLAS DR N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55422-2415
Country : US
Telephone Number : 612-642-1355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2025
Last Update Date : 05/22/2025

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Directions to “ EMMA RAE HAASE ” Practice Location

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