Healthcare Provider Details

I. General information

NPI: 1760786255
Provider Name (Legal Business Name): MARGARET J HAUCK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 06/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 S ROBERTSON ST 14 FLOOR
NEW ORLEANS LA
70112-2807
US

IV. Provider business mailing address

1430 TULANE AVE # 8055
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5405
  • Fax: 504-988-4264
Mailing address:
  • Phone: 504-988-5405
  • Fax: 504-988-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number707
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number707
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number707
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: