Healthcare Provider Details

I. General information

NPI: 1952354052
Provider Name (Legal Business Name): ELIZABETH HAIMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 04/16/2020
Certification Date: 04/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 QUAIL HOLLOW DR
PANAMA CITY BEACH FL
32408-4984
US

IV. Provider business mailing address

7108 QUAIL HOLLOW DR
PANAMA CITY BEACH FL
32408-4984
US

V. Phone/Fax

Practice location:
  • Phone: 850-819-5423
  • Fax:
Mailing address:
  • Phone: 850-819-5423
  • Fax: 850-769-2366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW4796
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: