Healthcare Provider Details

I. General information

NPI: 1285206334
Provider Name (Legal Business Name): NATASHA HASS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 07/16/2021
Certification Date: 07/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10907 NE 9TH AVE
BISCAYNE PARK FL
33161-7225
US

IV. Provider business mailing address

10907 NE 9TH AVE
BISCAYNE PARK FL
33161-7225
US

V. Phone/Fax

Practice location:
  • Phone: 305-345-3385
  • Fax:
Mailing address:
  • Phone: 305-345-3385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: